Amphetamine withdrawal management
The initial phase (crash) of withdrawal syndrome occurs as the stimulant effects wear off. Symptoms include:
- prolonged sleeping
- depressed mood (although some irritability even in the initial phase)
- some cravings (not usually severe in this initial phase).
The initial phase may last one to two days and then is followed by a longer period of several days to weeks of:
- mood changeability (irritability, depression, inability to experience pleasure)
- disturbed sleep
Psychotic symptoms may emerge during the first one to two weeks, particularly if they were present during times of use.
Amphetamine withdrawal is largely
An inpatient setting may be necessary if the patient has significant psychotic symptoms, in which case a referral to mental health services is appropriate.
No medication has been demonstrated to be effective in alleviating amphetamine withdrawal, but some medications may be
Antidepressants have been used for withdrawal-induced depression with some benefit, although
Short-term use of benzodiazepines (diazepam 5 to 10mg QID PRN) and antipsychotics (olanzapine 2.5-5mg BD PRN) for control of irritability and agitation can be helpful, particularly in the inpatient setting. Care should be taken to limit access to large quantities of medications and to avoid development of benzodiazepine dependence. These medications should be prescribed for a maximum of seven to 10 days.
Modafinil is also used at Drug and Alcohol Services South Australia and has been demonstrated to result in some improvement in symptoms, but this is not an approved medication for amphetamine withdrawal treatment.
The mainstay of treatment is supportive care and counselling.
Further information and advice
- Alcohol and Drug Information Service (ADIS) is a telephone information, counselling, and referral service. Telephone: 1300 13 1340
- Drug and Alcohol Clinical Advisory Service (DACAS) provides general practitioners and other health professionals direct telephone access to a specialist drug and alcohol medical officer. Telephone: (08) 7087 1742.