Paranoia

[LadyHalcyon]

Would be interested in any resources regarding treatment of paranoia and meth-abuse. Pt has been abstinent from meth use for 15 months but paranoia has persisted. Pt does not have a history of paranoia prior to meth use, but clinical interview revealed symptoms of PTSD-related hypervigilance (prior to paranoia). Pt used meth daily for approximately 6 to 9 months. Paranoia is very severe and impacting functioning.

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[temppsych123]

Interesting...I would think that a CBT for psychosis approach to targeting the paranoia might be helpful, regardless of what potentially caused/triggered/preceded the paranoia in the first place (given that the meth use is so distal at this point, it's presumably not acute withdrawal).

Here are a couple links that include lists of references, some of which are therapy manuals for CBTp:
https://www.nasmhpd.org/sites/default/files/DH-CBTp_Fact_Sheet.pdf
https://www.mirecc.va.gov/visn3/docs/CBTp_Manual_VA_Yulia_Landa_2017.pdf

 

[BuckeyeLove]

Meth. Is. Scary. I've seen this "settled" paranoia in several forensic patients that Courts/judges sometimes don't know what to do with adjudication-wise. Absolutely frightening the fragility of the mind in conjunction with some of these substances.

 

[LadyHalcyon]

Interesting...I would think that a CBT for psychosis approach to targeting the paranoia might be helpful, regardless of what potentially caused/triggered/preceded the paranoia in the first place (given that the meth use is so distal at this point, it's presumably not acute withdrawal).

Here are a couple links that include lists of references, some of which are therapy manuals for CBTp:
https://www.nasmhpd.org/sites/default/files/DH-CBTp_Fact_Sheet.pdf
https://www.mirecc.va.gov/visn3/docs/CBTp_Manual_VA_Yulia_Landa_2017.pdf

Thank you! I have never seen paranoia persist this long. It is VERY severe.

 

[LadyHalcyon]

Meth. Is. Scary. I've seen this "settled" paranoia in several forensic patients that Courts/judges sometimes don't know what to do with adjudication-wise. Absolutely frightening the fragility of the mind in conjunction with some of these substances.

Seriously. It is bad enough it is basically poison for your body but I can't believe her paranoia has persisted despite abstaining for 15 months. Unfortunately the wait-list for a psychiatrist in the area is ridiculously long but I am trying to coordinate with her PCP; I am thinking she may need an antipsychotic.

 

[AppsAintNoThang]

How old is the patient? You may be seeing the start or at least prodromal period of a more chronic psychotic disorder.

 

[cara susanna]

On internship I worked with a psychiatrist who was an expert on meth and psychosis, and he said that it can take a shockingly long enough of time for the effects in the brain to be fully reversed. I wish I could remember the exact amount of time, but I remember it was longer than a few months.

 

[LadyHalcyon]

How old is the patient? You may be seeing the start or at least prodromal period of a more chronic psychotic disorder.

She is 41

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