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West J Med. 1999 April; 170(4): 214–219.
PMCID: PMC1305551

Methamphetamine and the expanding complications of amphetamines.


During the past 10 years, the use of methamphetamine has increased rapidly in the West and throughout the United States. Because of this increase, our attention has focused on methamphetamine's toxicity. Methamphetamine and related compounds generate many of the same toxic effects as cocaine. Because of methamphetamine's widespread use, clinicians should be familiar with its medical effects and toxicity and with treatment options for acute and long-term effects of methamphetamine abuse.

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  • Bailey DN, Shaw RF. Cocaine- and methamphetamine-related deaths in San Diego County (1987): homicides and accidental overdoses. J Forensic Sci. 1989 Mar;34(2):407–422. [PubMed]
  • Stewart JL, Meeker JE. Fetal and infant deaths associated with maternal methamphetamine abuse. J Anal Toxicol. 1997 Oct;21(6):515–517. [PubMed]
  • Catanzarite VA, Stein DA. 'Crystal' and pregnancy--methamphetamine-associated maternal deaths. West J Med. 1995 May;162(5):454–457. [PMC free article] [PubMed]
  • Vega WA, Kolody B, Hwang J, Noble A. Prevalence and magnitude of perinatal substance exposures in California. N Engl J Med. 1993 Sep 16;329(12):850–854. [PubMed]
  • Puder KS, Kagan DV, Morgan JP. Illicit methamphetamine: analysis, synthesis, and availability. Am J Drug Alcohol Abuse. 1988;14(4):463–473. [PubMed]
  • Derlet RW, Rice P, Horowitz BZ, Lord RV. Amphetamine toxicity: experience with 127 cases. J Emerg Med. 1989 Mar-Apr;7(2):157–161. [PubMed]
  • Jackson JG. The hazards of smokable methamphetamine. N Engl J Med. 1989 Sep 28;321(13):907–907. [PubMed]
  • Kipke MD, O'Connor S, Palmer R, MacKenzie RG. Street youth in Los Angeles. Profile of a group at high risk for human immunodeficiency virus infection. Arch Pediatr Adolesc Med. 1995 May;149(5):513–519. [PubMed]
  • Klatt EC, Montgomery S, Namiki T, Noguchi TT. Misrepresentation of stimulant street drugs: a decade of experience in an analysis program. J Toxicol Clin Toxicol. 1986;24(5):441–450. [PubMed]
  • Derlet RW, Albertson TE. Emergency department presentation of cocaine intoxication. Ann Emerg Med. 1989 Feb;18(2):182–186. [PubMed]
  • Ellinwood EH., Jr Assault and homicide associated with amphetamine abuse. Am J Psychiatry. 1971 Mar;127(9):1170–1175. [PubMed]
  • Kalant H, Kalant OJ. Death in amphetamine users: causes and rates. Can Med Assoc J. 1975 Feb 8;112(3):299–304. [PMC free article] [PubMed]
  • Logan BK. Methamphetamine and driving impairment. J Forensic Sci. 1996 May;41(3):457–464. [PubMed]
  • Katsumata S, Sato K, Kashiwade H, Yamanami S, Zhou H, Yonemura I, Nakajima H, Hasekura H. Sudden death due presumably to internal use of methamphetamine. Forensic Sci Int. 1993 Dec;62(3):209–215. [PubMed]
  • Schepens PJ, Pauwels A, Van Damme P, Musuku A, Beaucourt L, Selala MI. Drugs of abuse and alcohol in weekend drivers involved in car crashes in Belgium. Ann Emerg Med. 1998 May;31(5):633–637. [PubMed]
  • Gawin FH, Ellinwood EH., Jr Cocaine and other stimulants. Actions, abuse, and treatment. N Engl J Med. 1988 May 5;318(18):1173–1182. [PubMed]
  • Cho AK. Ice: a new dosage form of an old drug. Science. 1990 Aug 10;249(4969):631–634. [PubMed]
  • Pitts DK, Marwah J. Cocaine and central monoaminergic neurotransmission: a review of electrophysiological studies and comparison to amphetamine and antidepressants. Life Sci. 1988;42(9):949–968. [PubMed]
  • Scheel-Krüger J. Behavioural and biochemical comparison of amphetamine derivatives, cocaine, benztropine and tricyclic anti-depressant drugs. Eur J Pharmacol. 1972 Apr;18(1):63–73. [PubMed]
  • Beckett AH, Rowland M. Urinary excretion kinetics of amphetamine in man. J Pharm Pharmacol. 1965 Oct;17(10):628–639. [PubMed]
  • Lake CR, Quirk RS. CNS stimulants and the look-alike drugs. Psychiatr Clin North Am. 1984 Dec;7(4):689–701. [PubMed]
  • Mendelson J, Jones RT, Upton R, Jacob P., 3rd Methamphetamine and ethanol interactions in humans. Clin Pharmacol Ther. 1995 May;57(5):559–568. [PubMed]
  • Kramer JC, Fischman VS, Littlefield DC. Amphetamine abuse. Pattern and effects of high doses taken intravenously. JAMA. 1967 Jul 31;201(5):305–309. [PubMed]
  • Lam D, Goldschlager N. Myocardial injury associated with polysubstance abuse. Am Heart J. 1988 Mar;115(3):675–680. [PubMed]
  • Bashour TT. Acute myocardial infarction resulting from amphetamine abuse: a spasm-thrombus interplay? Am Heart J. 1994 Dec;128(6 Pt 1):1237–1239. [PubMed]
  • Furst SR, Fallon SP, Reznik GN, Shah PK. Myocardial infarction after inhalation of methamphetamine. N Engl J Med. 1990 Oct 18;323(16):1147–1148. [PubMed]
  • Call TD, Hartneck J, Dickinson WA, Hartman CW, Bartel AG. Acute cardiomyopathy secondary to intravenous amphetamine abuse. Ann Intern Med. 1982 Oct;97(4):559–560. [PubMed]
  • Croft CH, Firth BG, Hillis LD. Propylhexedrine-induced left ventricular dysfunction. Ann Intern Med. 1982 Oct;97(4):560–561. [PubMed]
  • Smith HJ, Roche AH, Jausch MF, Herdson PB. Cardiomyopathy associated with amphetamine administration. Am Heart J. 1976 Jun;91(6):792–797. [PubMed]
  • O'Neill ME, Arnolda LF, Coles DM, Nikolic G. Acute amphetamine cardiomyopathy in a drug addict. Clin Cardiol. 1983 Apr;6(4):189–191. [PubMed]
  • Hong R, Matsuyama E, Nur K. Cardiomyopathy associated with the smoking of crystal methamphetamine. JAMA. 1991 Mar 6;265(9):1152–1154. [PubMed]
  • Citron BP, Halpern M, McCarron M, Lundberg GD, McCormick R, Pincus IJ, Tatter D, Haverback BJ. Necrotizing angiitis associated with drug abuse. N Engl J Med. 1970 Nov 5;283(19):1003–1011. [PubMed]
  • Davis GG, Swalwell CI. Acute aortic dissections and ruptured berry aneurysms associated with methamphetamine abuse. J Forensic Sci. 1994 Nov;39(6):1481–1485. [PubMed]
  • Wilson JM, Kalasinsky KS, Levey AI, Bergeron C, Reiber G, Anthony RM, Schmunk GA, Shannak K, Haycock JW, Kish SJ. Striatal dopamine nerve terminal markers in human, chronic methamphetamine users. Nat Med. 1996 Jun;2(6):699–703. [PubMed]
  • ZALIS EG, PARMLEY LF., Jr FATAL AMPHETAMINE POISONING. Arch Intern Med. 1963 Dec;112:822–826. [PubMed]
  • Conci F, D'Angelo V, Tampieri D, Vecchi G. Intracerebral hemorrhage and angiographic beading following amphetamine abuse. Ital J Neurol Sci. 1988 Feb;9(1):77–81. [PubMed]
  • Hall AP, Lyburn ID, Spears FD, Riley B. An unusual case of Ecstasy poisoning. Intensive Care Med. 1996 Jul;22(7):670–671. [PubMed]
  • Chynn KY. Acute subarachnoid hemorrhage. JAMA. 1975 Jul 7;233(1):55–56. [PubMed]
  • Salanova V, Taubner R. Intracerebral haemorrhage and vasculitis secondary to amphetamine use. Postgrad Med J. 1984 Jun;60(704):429–430. [PMC free article] [PubMed]
  • Smith DE, Fischer CM. An analysis of 310 cases of acute high-dose methamphetamine toxicity in Haight-Ashbury. Clin Toxicol. 1970 Mar;3(1):117–124. [PubMed]
  • Sato M. A lasting vulnerability to psychosis in patients with previous methamphetamine psychosis. Ann N Y Acad Sci. 1992 Jun 28;654:160–170. [PubMed]
  • Rhee KJ, Albertson TE, Douglas JC. Choreoathetoid disorder associated with amphetamine-like drugs. Am J Emerg Med. 1988 Mar;6(2):131–133. [PubMed]
  • Lundh H, Tunving K. An extrapyramidal choreiform syndrome caused by amphetamine addiction. J Neurol Neurosurg Psychiatry. 1981 Aug;44(8):728–730. [PMC free article] [PubMed]
  • Henry JA, Jeffreys KJ, Dawling S. Toxicity and deaths from 3,4-methylenedioxymethamphetamine ("ecstasy") Lancet. 1992 Aug 15;340(8816):384–387. [PubMed]
  • Simpson DL, Rumack BH. Methylenedioxyamphetamine. Clinical description of overdose, death, and review of pharmacology. Arch Intern Med. 1981 Oct;141(11):1507–1509. [PubMed]
  • Chan P, Chen JH, Lee MH, Deng JF. Fatal and nonfatal methamphetamine intoxication in the intensive care unit. J Toxicol Clin Toxicol. 1994;32(2):147–155. [PubMed]
  • Lukes SA. Intracerebral hemorrhage from an arteriovenous malformation after amphetamine injection. Arch Neurol. 1983 Jan;40(1):60–61. [PubMed]
  • Matick H, Anderson D, Brumlik J. Cerebral vasculitis associated with oral amphetamine overdose. Arch Neurol. 1983 Apr;40(4):253–254. [PubMed]
  • Hughes JC, McCabe M, Evans RJ. Intracranial haemorrhage associated with ingestion of 'ecstasy'. Arch Emerg Med. 1993 Dec;10(4):372–374. [PMC free article] [PubMed]
  • Rothrock JF, Rubenstein R, Lyden PD. Ischemic stroke associated with methamphetamine inhalation. Neurology. 1988 Apr;38(4):589–592. [PubMed]
  • Gospe SM., Jr Transient cortical blindness in an infant exposed to methamphetamine. Ann Emerg Med. 1995 Sep;26(3):380–382. [PubMed]
  • Molitor F, Truax SR, Ruiz JD, Sun RK. Association of methamphetamine use during sex with risky sexual behaviors and HIV infection among non-injection drug users. West J Med. 1998 Feb;168(2):93–97. [PMC free article] [PubMed]
  • Gorman EM, Morgan P, Lambert EY. Qualitative research considerations and other issues in the study of methamphetamine use among men who have sex with other men. NIDA Res Monogr. 1995;157:156–181. [PubMed]
  • Meston CM, Gorzalka BB. Psychoactive drugs and human sexual behavior: the role of serotonergic activity. J Psychoactive Drugs. 1992 Jan-Mar;24(1):1–40. [PubMed]
  • Albertson TE, Walby WF, Derlet RW. Stimulant-induced pulmonary toxicity. Chest. 1995 Oct;108(4):1140–1149. [PubMed]
  • Arnett EN, Battle WE, Russo JV, Roberts WC. Intravenous injection of talc-containing drugs intended for oral use. A cause of pulmonary granulomatosis and pulmonary hypertension. Am J Med. 1976 May 10;60(5):711–718. [PubMed]
  • Robertson CH, Jr, Reynolds RC, Wilson JE., 3rd Pulmonary hypertension and foreign body granulomas in intravenous drug abusers. Documentation by cardiac catheterization and lung biopsy. Am J Med. 1976 Nov;61(5):657–664. [PubMed]
  • Lewman LV. Fatal pulmonary hypertension from intravenous injection of methylphenidate (Ritalin) tablets. Hum Pathol. 1972 Mar;3(1):67–70. [PubMed]
  • Schaiberger PH, Kennedy TC, Miller FC, Gal J, Petty TL. Pulmonary hypertension associated with long-term inhalation of "crank" methamphetamine. Chest. 1993 Aug;104(2):614–616. [PubMed]
  • Sperling LS, Horowitz JL. Methamphetamine-induced choreoathetosis and rhabdomyolysis. Ann Intern Med. 1994 Dec 15;121(12):986–986. [PubMed]
  • Kendrick WC, Hull AR, Knochel JP. Rhabdomyolysis and shock after intravenous amphetamine administration. Ann Intern Med. 1977 Apr;86(4):381–387. [PubMed]
  • Ginsberg MD, Hertzman M, Schmidt-Nowara WW. Amphetamine intoxication with coagulopathy, hyperthermia, and reversible renal failure. A syndrome resembling heatstroke. Ann Intern Med. 1970 Jul;73(1):81–85. [PubMed]
  • Screaton GR, Singer M, Cairns HS, Thrasher A, Sarner M, Cohen SL. Hyperpyrexia and rhabdomyolysis after MDMA ("ecstasy") abuse. Lancet. 1992 Mar 14;339(8794):677–678. [PubMed]
  • Callaway CW, Clark RF. Hyperthermia in psychostimulant overdose. Ann Emerg Med. 1994 Jul;24(1):68–76. [PubMed]
  • Foley RJ, Kapatkin K, Verani R, Weinman EJ. Amphetamine-induced acute renal failure. South Med J. 1984 Feb;77(2):258–260. [PubMed]
  • de Man RA, Wilson JH, Tjen HS. Acuut leverfalen door methyleendioxymetamfetamine ('ecstacy'). Ned Tijdschr Geneeskd. 1993 Apr 3;137(14):727–729. [PubMed]
  • Jones AL, Jarvie DR, McDermid G, Proudfoot AT. Hepatocellular damage following amphetamine intoxication. J Toxicol Clin Toxicol. 1994;32(4):435–444. [PubMed]
  • Johnson TD, Berenson MM. Methamphetamine-induced ischemic colitis. J Clin Gastroenterol. 1991 Dec;13(6):687–689. [PubMed]
  • Pecha RE, Prindiville T, Pecha BS, Camp R, Carroll M, Trudeau W. Association of cocaine and methamphetamine use with giant gastroduodenal ulcers. Am J Gastroenterol. 1996 Dec;91(12):2523–2527. [PubMed]
  • Cadier MA, Clarke JA. Ecstasy and Whizz at a rave resulting in a major burn plus complications. Burns. 1993 Jun;19(3):239–240. [PubMed]
  • Deloach-Banta LJ. Lichenoid drug eruption: crystal methamphetamine or adulterants? Cutis. 1994 Feb;53(2):97–98. [PubMed]
  • Richards JR, Derlet RW, Duncan DR. Methamphetamine toxicity: treatment with a benzodiazepine versus a butyrophenone. Eur J Emerg Med. 1997 Sep;4(3):130–135. [PubMed]
  • Gary NE, Saidi P. Methamphetamine intoxication. A speedy new treatment. Am J Med. 1978 Mar;64(3):537–540. [PubMed]

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