Substance Misuse To Psychosis for Ketamine (SToP-K)

The University of Hong Kong162 enrolled

Overview

Evidence suggests that repeated or chronic ketamine use, as compared to acute ketamine users, posed a higher clinical risk of developing psychotic disorders, potentially related to the underlying chronic N-methyl-D-aspartate receptor (NMDAR) dysfunction, and a higher risk of suffering from schizophrenia particularly in those genetically susceptible, or genetically predisposed ketamine abusers. With ketamine infusion rises as a emerging hope as an acute treatment for depression and suicidality under the shadow of unknown longer term psychotomimetic effects peculiarly amongst repeated or chronic use, the current case-control study aims to investigate: a) if repeated or chronic ketamine use is associated with an increased risk of psychosis by comparing those ketamine abusers with and without psychosis, and to those non-ketamine-using drug abusers with psychosis; and b) if genetic predisposition from single nucleotide polymorphisms are associated with risk of psychosis in ketamine abusers.

Study Type

OBSERVATIONAL

Enrollment

162

Conditions

Ketamine Abuse Psychotic Disorders Substance Use Disorders Schizophrenia Genetic Predisposition

Eligibility

Sex: ALLMin age: 12 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age: 12 - 65 years old * Able to read and communicate in English and/or Chinese * Able to give informed consent * Self-reported to have psychoactive substance use continuously for ≥3 month * At least one positive urine toxicology result showing the reported psychoactive substance being used Exclusion Criteria: * Age \<12 years old * Unable to read English or Chinese * Unable to give informed consent * Had been diagnosed to have Intellectual Disabilities (DSM-5) or Mental Retardation (ICD-10, F70-73) * Had been diagnosed to have primary psychosis prior to the use of any psychoactive substances, including alcohol * Had been diagnosed to have "bipolar and related disorder" prior to the use of any psychoactive substances, including alcohol * Had been diagnosed to have "major depressive disorder with psychotic features" prior to the use of any psychoactive substances, including alcohol * Had been diagnosed to have "psychotic disorder due to another medical condition" (DMS-5) * Self-reported to have abstained from any psychoactive substance use continuously for ≥12 months AND with negative urine toxicology result at the time of recruitment/ intake at the psychiatric services as recorded on case notes

Outcomes

Primary Outcomes

relative risk of ketamine users compared to non-ketamine using drug user to develop psychosis

Time frame: During the 2 year study period

Secondary Outcomes

Gene association to development of psychcosis

The single nucleotide polymorphism of 4 genes associated with N-methyl-D-aspartate and dopamine receptors being associated with the development of psychosis in ketamine abuser