Cognitive and psychiatric outcomes of methamphetamine (Shabu Drug) abstinence: a 6-months longitudinal study in Tanta, Egypt

Abstract

Abstract Background and objectives Methamphetamine use is increasing globally not only in developed countries but also in developing countries, including Egypt. The adverse impact of methamphetamine use (locally known as Shabu drug in Egypt) on psychiatric condition and cognitive functions has been described in previous studies, but limited evidence is available for abstinent users from prospective longitudinal studies especially in Egypt. The aim of this study was to assess the longitudinal changes in cognitive functions, anxiety, depression, and suicidality among methamphetamine users over 6 months of abstinence. Methods This prospective longitudinal study was conducted with baseline and two follow-up interviews every 3 months over 6 months of abstinence in 30 participants who were current or recent methamphetamine (shabu) users at baseline, in both the Inpatient and Outpatient Treatment Setting of the Neurology & Psychiatry Department, and Psychiatry, Neurology and Neurosurgery Centre in Tanta University Hospitals from July 2025 to December 2025. All patients underwent the assessment of socioeconomic data, assessment of patient’s level of depression by Beck depression inventory–II (BDI-II), the level of anxiety by generalized anxiety disorder-7 scale (GAD-7), the suicidal behaviour by Beck scale for suicidal ideation (BSSI) and assessment of cognitive functions by Montreal cognitive assessment (MoCA) test. Results The depression, anxiety and suicidality (assessed by previous measures) were significantly lower at T1 (after 3 months of abstinence) and T2 (after 6 months of abstinence) than T0 (baseline with recent methamphetamine use) ( P < 0.05) and were significantly lower at T2 than T1 ( P < 0.05). Regarding cognitive functions (assessed by Montreal cognitive assessment test, MoCA), the attention, naming, visual space/ executive function subscale scores and the total MoCA score were significantly higher at T1 and T2 than T0 ( P < 0.05) and was significantly higher at T2 than T1 ( P < 0.05). The language skills, and the memory and delayed recall subscale scores were significantly higher at T1 and T2 than T0 ( P < 0.05), with insignificant difference between T1 and T2. The abstract ability subscale score was significantly higher at T2 (6 months) than T0 (baseline) ( P < 0.05), with insignificant difference between T1 and T0. The orientation domain didn’t show statistical difference across three different time points of assessment. Conclusions Depression, anxiety, suicidal ideation and cognitive impairment were found to be high among current methamphetamine users, which showed significant improvement during 6 months of the methamphetamine abstinence.