Home Health Big Book of Emergency Department Psychiatry
Per the ICD 10, the stimulant use disorders include stimulant use disorder F14, F15.10, and F15.20, stimulant intoxication F15.129, F15.229, F15.929, and so on, stimulant withdrawal F14.23 and F15.23, other stimulant-induced disorders, unspecified stimulant-related disorder F14.99 and 15.99, mild cocaine use disorder F 14.10, moderate/severe F14.20, and amphetamine type use disorder F15.1 and F15.2.
Stimulants exert their effects via the catecholaminergic and sympathetic nervous system, for instance, norepinephrine and dopaminergic pathways. They include naturally existing alkaloids, such as those found in the coca plant and ma-huang, and synthetics compounds, such as amphetamine, lisdexamfetamine, methamphetamine, methylphenidate, and other phenethylamines (Fischman and Foltin 2016).
Stimulant Intoxication and Withdrawal
Some of the commonly abused stimulants include amphetamines, methamphetamines, and cocaine. A myriad of physiological changes can occur in a patient that is acutely intoxicated or actively withdrawing from a stimulant. According to the DSM-5, symptoms of acute intoxication can include pulse changes, mydriasis, blood pressure changes, nausea and vomiting, diaphoresis and chills, psychomotor changes, cardiovascular changes, confusion, seizures, dystonia, and coma, with or without perceptual changes (American Psychiatric Association 2013). Withdrawal symptoms can include fatigue, vivid dreams, sleep changes, increased appetite, and psychomotor changes.
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