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Amphetamine withdrawal

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292.0 Amphetamine Withdrawal

Refer, in addition, to the text and criteria for Substance Withdrawal (see p. 201). The essential feature of Amphetamine Withdrawal is the presence of a characteristic withdrawal syndrome that develops within a few hours to several days after cessation of (or reduction in) heavy and prolonged amphetamine use (Criteria A and B). The symptoms of withdrawal are, in general, the opposite of those seen during intoxication. The withdrawal syndrome is characterized by the development of dysphoric mood and two or more of the following physiological changes: fatigue, vivid and unpleasant dreams, insomnia or hypersomnia, increased appetite, and psychomotor retardation or agitation. Anhedonia and drug craving can also be present but are not part of the diagnostic criteria. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion C). The symptoms must not be due to a general medical condition and are not better accounted for by another mental disorder.

Marked withdrawal symptoms ("crashing") often follow an episode of intense, high-dose use (a "speed run"). This "crash" is characterized by intense and unpleasant feelings of lassitude and depression, generally requiring several days of rest and recuperation. Weight loss commonly occurs during heavy stimulant use, whereas a marked increase in appetite with rapid weight gain is often observed during withdrawal. Depressive symptoms may last several days to weeks and may be accompanied by suicidal ideation. The vast majority of individuals with Amphetamine Dependence have experienced a withdrawal syndrome at some point in their lives, and virtually all report tolerance.

Diagnostic criteria for 292.0 Amphetamine Withdrawal

  1. Cessation of (or reduction in) amphetamine (or a related substance) use that has been heavy and prolonged.
  2. Dysphoric mood and two (or more) of the following physiological changes, developing within a few hours to several days after Criterion A:
    1. fatigue
    2. vivid, unpleasant dreams
    3. insomnia or hypersomnia
    4. increased appetite
    5. psychomotor retardation or agitation
  3. The symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  4. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder.
Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text RevisionTM. Copyright 2000 American Psychiatric Association. All Rights Reserved.