精神活性物质所致精神障碍

Amphetamine-related mental disorder

1病史摘要 患者，男，35岁，因“反复使用冰毒4年，易激惹2个月，猜疑，耳闻入语伴失眠10d”第二次入住上海市精神卫生中心戒毒科。患者于2006年在朋友影响下，因好奇开始吸食冰毒（甲基苯丙胺），当时人很兴奋，不停地说话。最初1～2个月才使用一次。2007年使用频率增加，有时隔几天一次，后来几乎每天使用，每次1～6条，剂量不等。

A 35-year-old male with a 4-year history of amphetamine abuse was admitted after 10 days of psychotic symptoms. The symptoms resolved after ]0 days of treatment with olanzapine and he remained abstinent from amphetamine use for 5 months after discharge, as verified by urine tests at three clinic visits. This case is used to discuss several related issues： the source and classification of amphetamine drugs, the prevalence of amphetamine abuse in youth, the differential diagnosis in drug abusers, clinical problems in managing amphetamine abuse, and the mechanisms underlying the brain changes associated with amphetamine use.