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We have conducted a narrative review of neuropsychiatric harms associated with the psychostimulants methamphetamine\/amphetamine, cocaine and 3,4\u2010methylenedioxymethamphetamine (MDMA), focusing on epidemiological factors, common clinical presentations, underlying causal mechanisms and treatment options. The major neuropsychiatric harms of psychostimulant use are stroke, neurocognitive impairment, Parkinson's disease, seizures and psychotic illness. These arise through a combination of acute monoamine release, longer\u2010term neurotransmitter effects and indirect effects. These effects are moderated by factors in the individual and in the pattern of substance use. Neuropsychiatric harms associated with psychostimulant use can thus lead to severe long\u2010term impairment.<\/jats:p>","DOI":"10.1111\/add.14708","type":"journal-article","created":{"date-parts":[[2019,7,19]],"date-time":"2019-07-19T03:42:20Z","timestamp":1563507740000},"page":"2065-2077","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":97,"title":["Psychostimulant use and the brain"],"prefix":"10.1111","volume":"114","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5946-2144","authenticated-orcid":false,"given":"Julia M.","family":"Lappin","sequence":"first","affiliation":[{"name":"National Drug and Alcohol Research Centre (NDARC) University of New South Wales  Sydney Australia"},{"name":"School of Psychiatry University of New South Wales  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant E.","family":"Sara","sequence":"additional","affiliation":[{"name":"InforMH, NSW Ministry of Health  North Ryde NSW Australia"},{"name":"Northern Clinical School, Sydney Medical School The University of Sydney  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,19]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"United Nations Office on Drugs and Crime (UNODC).United Nations Office on Drugs and Crime World Drug Report 2017. 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