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Clinical features of methamphetamine‐induced paranoia and preliminary genetic association with DBH ‐1021 C → T in a T hai treatment cohort
Author(s) -
Kalayasiri Rasmon,
Verachai Viroj,
Gelernter Joel,
Mutirangura Apiwat,
Malison Robert T.
Publication year - 2014
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.12512
Subject(s) - medicine , methamphetamine , substance dependence , paranoia , alcohol dependence , cohort , odds ratio , logistic regression , psychiatry , substance abuse , psychology , alcohol , biology , biochemistry
Aims To explore the clinical features of methamphetamine‐induced paranoia ( MIP ) and associations between MIP and a genetic polymorphism in dopamine β‐hydroxylase ( DBH ‐1021 C → T ). Design Retrospective analysis of clinical presentation and genetic association by χ 2 test and logistic regression analysis. Setting A T hai substance abuse treatment center. Participants A total of 727 methamphetamine‐dependent ( MD ) individuals. Measurements Clinical: Semi‐Structured Assessment for Drug Dependence and Alcoholism ( SSADDA ) and the Methamphetamine Experience Questionnaire ( MEQ ). Genetic: DBH ‐1021 C → T . Findings Forty per cent of individuals (289 of 727; 39.8%) with MD had MIP . Within‐binge latency to MIP onset occurred more rapidly in the most recent compared with initial MIP episode ( P = 0.02), despite unchanging intake ( P = 0.89). Individuals with MIP were significantly less likely to carry lower ( TT / CT ) compared with higher ( CC ) activity genotypes (34.3 versus 43.3%; χ 2 1 = 5, P = 0.03). DBH effects were confirmed [odds ratio ( OR) = 0.7, P = 0.04] after controlling for associated clinical variables ( MD severity, OR = 3.4, P < 0.001; antisocial personality disorder, OR = 2.2, P < 0.001; alcohol dependence, OR = 1.4, P = 0.05; and nicotine dependence, OR = 1.4, P = 0.06). TT / CT carriers were more likely to initiate cigarette smoking ( OR = 3.9, P = 0.003) and probably less likely to be dependent on alcohol ( OR = 0.6, P = 0.05). Conclusions Among methamphetamine‐dependent individuals, paranoia appears to occur increasingly rapidly in the course of a session of methamphetamine use. Severity of methamphetamine dependence and antisocial personality disorder predicts methamphetamine‐induced paranoia. The genetic polymorphism in dopamine β‐hydroxylase is associated with methamphetamine‐induced paranoia and influences smoking initiation.