Substance/Medication-Induced Psychotic Disorder

Definition

When prescription medications, recreational drugs, or excessive alcohol use provoke psychotic symptoms, the condition is diagnosed as Substance/Medication-Induced Psychotic Disorder. Anyone with an established mental health problem, or who is prone to psychosis, is at a higher risk of developing a psychotic disorder from over-intoxication or abuse of a legal or illegal substance.

Symptoms

As with any other psychotic conditions, the primary symptoms of Substance/Medication-Induced Psychotic Disorder are hallucinations and delusions. They are more severe than what may be considered routine symptoms of intoxication or withdrawal. Symptoms are generally acute, lasting only until the substance or medication is cleared from the body. In some cases, however, psychotic symptoms may continue for up to several weeks. 

Causes

Substance/Medication-Induced Psychotic Disorder can occur with the use of, or withdrawal from, alcohol, drugs, and even prescription medications such as opioids and sedatives/hypnotics. Other substances that can trigger a psychotic event include cocaine, amphetamines, phencyclidine (PCP) and alcohol. More than half of methamphetamine users have experienced short- or long-term psychosis. Studies have found that chronic use of cannabis (marijuana or hashish) can also induce psychotic disorders.

Treatments

Substance/Medication-Induced Psychosis incidents are often seen in hospital emergency rooms and mental health crisis intervention centers. A physician must first determine if psychotic symptoms due to a mental health condition or to the substance itself. Antipsychotic or antianxiety medication such as benzodiazepine is often administered to reduce symptoms. Depending on the type of substance that triggered the psychotic event, treatment may simply consist of monitoring the patient in a calm, quiet environment.

References

Schulz SC. Merck Manual website. Substance/Medication Induced Psychotic Disorder.  Last reviewed July 2016. Accessed June 1, 2016.

Hides L, Dawe S, McKetin R, et al. Primary and substance-induced psychotic disorders in methamphetamine users. Psychiatry Research. 30 March 2015;226(1):91-96.

Bloomfield MAP, Morgan CJA, Egerton A, et al. Dopaminergic function in cannabis users and its relationship to cannabis-induced psychotic symptoms. Biological Psychiatry. 15 March 2014;75(6):470-478.

Last reviewed 06/06/2017