Meth can cause so much disorganization and delusion that, even after stopping, a person looks exactly like someone with schizophrenia. Still, even when everyone agrees it is the meth, do not automatically assume that is the whole story. For meth use disorder, mirtazapine gives only a small but statistically significant drop in some populations: about three fewer meth days a month.
Diagnosis and differential
Meth can cause so much disorganization, delusions and odd belief systems that, even if the person stops using, they look exactly the same as someone with schizophrenia.
“someone can can cause so much disorganization and delusions and odd belief systems in their brain that now there's no different there's no if this person were to stop using meth they'll look the exact same as someone who has schizophrenia”
23:49What is Psychosis? Look at the DSM, Common Mimics, and a Framework for the DifferentialJan 2026 Even when the patient, the parents and you yourself have all said it is the meth, do not automatically assume that is that.
“just because everyone has told you that it's meth, the patient has told you, you have told yourself that it's meth, and the parents have told you that it's meth, doesn't mean that you should automatically assume that's that”
26:16Involuntary Treatment & Agency, Thoughts and Feelings | Episode 19Mar 2025
Treating meth use disorder
The reduction in meth use disorder is pathetic but still statistically significant in some populations: something like three fewer meth days in the month.
“also has a pathetic, but still statistically significant reduction in some populations for meth use disorder. You can get like three less meth days in the month”
49:09Antidepressant Tier List: Psychiatrists Rank Depression Medications for MDDMay 2026
It also comes up on
- AmphetamineWhat you feel on a stimulant (meth, cocaine or speed, which is what Adderall is) is an intoxicant effect: the euphoria and energy burst, and you build tolerance to that.
- Psychiatric interviewDo not stop at do you use any substances. Go through alcohol, then cannabis, then ask whether there was ever a time they used anything else (cocaine, painkillers, methamphetamine), and normalize it.
From these episodes
Every point above is something said on the Psychofarm podcast, with the words as spoken and a link to the moment in the episode. It is education, not medical advice, and an episode reflects what we thought when we recorded it.