Relapse of panic disorder induced by a single intravenous methamphetamine injection

An association study between catechol-O-methyl transferase gene polymorphism and methamphetamine psychotic disorder

OBJECTIVE

A series of methamphetamine psychosis reveals two kinds of clinical courses of methamphetamine psychosis: transient type and prolonged type. Furthermore, paranoid psychosis sometimes recurs without methamphetamine reuse, referred to as spontaneous relapse. Dysfunction of central dopaminergic neurotransmission has been implicated in the pathogenesis of these psychiatric states. Catechol-O-methyl transferase appears to play a unique role in regulating synaptic dopaminergic activity. This study aimed to investigate whether a functional polymorphism of the catechol-O-methyl transferase gene would be involved in the development of these psychiatric states.

BASIC METHODS

We examined the functional polymorphism of val 158 met (catechol-O-methyl transferase) in 143 patients with methamphetamine psychosis and 200 healthy controls in Japan. The patients were divided into subgroups by several characteristic clinical features.

MAIN RESULTS

We found a significant difference in the catechol-O-methyl transferase allele frequency between patients with spontaneous relapse and the controls (P=0.018, odds ratio=1.67). Odds ratio implied that the patients with spontaneous relapse had a nearly 1.7-fold higher rate of the low activity alleles (met) than the controls.

CONCLUSIONS

Our results indicate that the met allele frequency of the catechol-O-methyl transferase is associated with patients who experienced methamphetamine psychosis and spontaneous relapse, suggesting that patients with a met allele appear to be at increased risk of an adverse response to methamphetamine.

Relationship between panic and schizophrenia

Although panic attacks and schizophrenic symptoms are common comorbid conditions, little is known about the reason for this association. A critical review of the literature on the association between panic attacks and schizophrenic symptoms is presented. The findings reported in the literature are discussed as evidence for one of four competing hypotheses: 1) the reported association is due to a methodological artifact, 2) panic attacks cause schizophrenic symptoms, 3) schizophrenic symptoms cause panic attacks, and 4) panic attacks and schizophrenic symptoms share common etiologic factors. No firm conclusions can be drawn due to insufficient empirical data. The best preliminary explanation for the association is that the two disorders share common etiologic factors.