The present study was conducted to evaluate plasma levels of monoamine neurotransmitter metabolites in spontaneous recurrences of methamphetamine psychosis (i.e., flashbacks). The subjects were 50 physically healthy females comprised of 25 who experienced flashbacks (flashbackers), 18 who did not experienced methamphetamine psychosis, and 9 who were currently suffering from persistent methamphetamine psychosis. The control data were available from 28 normal healthy females, of whom 20 had previously abused methamphetamine (users) and 8 who had not (nonusers), none of whom had ever become psychotic. Plasma levels of norepinephrine (NE), dopamine (DA), and 5-hydroxytryptamine (5-HT), and their respective metabolites were assayed. Plasma NE levels were significantly higher in the 25 flashbackers during their flashbacks than during their periods of normalcy, and were significantly higher than those in the 20 user and 8 nonuser controls. Plasma 3-methoxy-4-hydroxyphenylglycol (MHPG) levels during flashbacks were significantly higher than those in the 20 user controls. The nine subjects with persistent methamphetamine psychosis had significantly higher NE levels than the user and nonuser controls. The 16 nonflashbackers had significantly higher MHPG levels than the user controls. The present study suggests that an increase in peripheral noradrenergic activity is related to the occurrence of flashbacks.