Table 1.
Medical complications of stimulant use
| Organ system | Acute | Chronic |
|---|---|---|
| Nervous system | Agitation | Psychotic symptoms, mood disorders |
| Hallucinations, esp. tactile | Cerebrovascular disease/stroke | |
| Dyskinesia | Cognitive impairment | |
| Cognitive impairment | Movement disorders, e.g., dystonic reactions, akathisia, choreoathetosis, tardive dyskinesia | |
| Cardiovascular system | Tachycardia | Malignant hypertension |
| Hypertension | Myocarditis | |
| Coronary artery vasospasm | Cardiomyopathy | |
| Myocardial infarction | Pulmonary hypertension | |
| Arrhythmias | Accelerated atherosclerosis | |
| Thoracic aortic dissection | Acute coronary syndrome | |
| Pulmonary | Cough, shortness of breath | Interstitial pneumonitis |
| Reactive airways disease | Bronchiolitis obliterans | |
| Pulmonary edema, hemorrhage | Pulmonary hypertension | |
| Pneumothorax | ||
| Renal | Acute renal failure | Renal ischemia |
| Glomerulonephritis | ||
| Chronic renal failure | ||
| Gastrointestinal | Reduced gastric motility | Gastric ulceration and perforation |
| GI bleeding | Intestinal infarction | |
| Ischemic colitis | ||
| Liver | Viral hepatitis and HIV | |
| Endocrine | Reduced prolactin | Inc, normal or dec. prolactin |
| Increased epinephrine, CRH, ACTH, cortisol and LH | Normal testosterone, cortisol, LH, thyroid hormones | |
| Musculoskeletal | Movement disorders (see CNS) | Rhabdomyolysis |
| Head and neck | Rhinitis | Rhinitis, sinusitis |
| Perforated nasal septum | ||
| Nasal and gingival ulceration | ||
| Dental decay and periodontal disease | ||
| Xerostomia | ||
| Corneal ulcers | ||
| Immune system | Vasculitis syndromes | |
| Sexual function | Erectile dysfunction | |
| Irregular menses | ||
| Reproductive | Vaginal bleeding | FDA category C |
| Abruption placenta | Placenta previa | |
| Premature rupture of membranes | Low birth weight | |
| Dermatologic | Skin and soft tissue infections | |
| General/other | Dehydration | Weight loss |
| Hyperthermia | Nutritional deficits |