A patient is brought to the emergency department by a family member. The patient has been agitated for the past several hours and has alternated between grandiosity and expressing a desire to commit suicide. Upon examination, the patient is diaphoretic, hypertensive, and tachycardic. Intoxication with which of the following substances would contribute to these symptoms?

Methamphetamine intoxication causes a surge of adrenergic stimulation secondary to increased epinephrine and norepinephrine. Methamphetamine use and overdose can be life-threatening. Physical signs are hypertension, tachycardia and arrhythmia, which can lead to circulatory collapse. Hyperthermia and seizures may occur. Behavior changes can include insomnia, anxiety, aggression, hallucinations, mood disturbances, and paranoia. The patient's presentation is related to decreased monoamine degradation and an increased amount of monoamines in the nervous system synapses.