stereotyped and repetitive behavior, anger, impaired judgment, and, in the case of chronic
intoxication, affective blunting with fatigue or sadness and social withdrawal. These be-
havioral and psychological changes are acco mpanied by two or more of the following
signs and symptoms that develop during or sh ortly after stimulant us e: tachycardia or bra-
dycardia; pupillary dilation; el evated or lowered blood pressu re; perspiration or chills;
nausea or vomiting; evidence of weight loss ; psychomotor agitation or retardation; mus-
cular weakness, respiratory depression, chest pain, or card iac arrhythmias; and confu-
sion, seizures, dyskinesias, dystonias, or coma  (Criterion C). Intoxi cation, either acute or
chronic, is often associated with impaired so cial or occupational functioning. Severe in-
toxication can lead to convulsions, cardiac arrhythmias, hyperpyrexia, and death. For the
diagnosis of stimulant intoxica tion to be made, the symptoms must not be attributable
to another medical condition and not better explained by anot her mental disorder (Crite-
rion D). While stimulant intoxica tion occurs in individuals with stimulant use disorders, in-
toxication is not a criterion for stimulant us e disorder, which is confirmed by the presence
of two of the 11 diagnostic criteria for use disorder. 
Associated Features Supporting Diagnosis
The magnitude and direction of the behavioral  and physiological changes depend on many
variables, including the dose used and the ch aracteristics of the individual using the sub-
stance or the context (e.g., tolerance, rate of absorption, chronicity of use, context in which