Drug addiction and treatment compliance

Shirley Taniguchi

Abstract

Statement of the problem: Neuroleptic-induced extrapyramidal symptoms may hinder adherence to drug rehabilitation treatment. Methodology and Theoretical Orientations: This study included 32 patients (mean age of 33.61±1.90) admitted to a public mental health service in São Paulo (Brazil) due to psychotic symptoms associated with illicit drug use. Findings: A total of 80.65% of patients were addicted to alcohol alone or alcohol plus cocaine or crack, while 19.35% were addicted to cocaine or crack cocaine Psychosis (73.08%), aggressive behavior (7.69%), and withdrawal syndrome (11.10% ), while no effects were registered in the remaining 7.69%. Among cocaine abusers, we observed hallucinations and delirium (50%), cardiovascular effects (27.76%), and psychomotor agitation (11.12%), while no effects were observed in the remaining 11.10%. Among crack users, we observed hallucinations and delirium (50%), and cardiovascular effects (37.50%), while no effects were observed among the remaining 12.50% of patients. Hallucinations, delirium, psychomotor agitation and psychosis were treated with typical or atypical neuroleptics (96.88%) or anticonvulsants (3.12%). A total of 80.64% of patients receiving neuroleptics had extrapyramidal symptoms (acute dystonia akathisia, pharmacological parkinsonism), which were treated with a centrally acting anticholinergic drug-biperiden (60%) or anticonvulsants/anti histaminics (40%). Conclusions and significance: Professionals should reconsider the use of typical neuroleptics to treat drug-induced hallucinations, delirium and psychosis. Their side effects make it difficult for patients to adhere to treatment Thus, any neuroleptic-induced side effects should always be carefully monitored