Which Drugs Induce Psychosis?

Experiencing drug-induced psychosis can be very upsetting, but it is usually resolvable within a few days if a person is given the appropriate treatment. 

Additionally, some people may develop schizophrenia with drug use, which is a superficially similar but a different and more serious occurrence. Generally, these individuals were already prone to the development of the mental health disorder.

What Is Drug-Induced Psychosis?

As defined by the DSM-5, drug-induced psychosis, which is called substance-induced psychotic disorder, is a psychiatric disease where a person experiences delusions and/or hallucinations during or soon after taking drugs or going through withdrawal. 

At present, this type of psychosis is specifically defined as having developed within a month after substance intoxication or withdrawal. Some experts have argued this may be an inadequate window, with some people experiencing drug-induced psychosis even later after drug use or withdrawal and for whom other psychiatric conditions that can cause psychosis would not be an appropriate diagnosis.

What Common Drugs Can Cause Psychosis?

While we don’t completely understand substance-induced psychosis, modern literature suggests its occurrence is related to several mechanisms, including these:

• Higher levels of central dopamine
• A cannabinoid CB1-receptor agonist
• A 5HT2A-receptor agonist
• Antagonist activity at NMDA receptors
• Activation of the k-opioid receptor 

 

The following relatively common drugs are believed to potentially cause psychosis, especially with significant abuse and when used over longer periods:

• Alcohol
• Methamphetamines (meth)
• Cannabis
• Cocaine
• MDMA
• Opioids
• Ketamine
• PCP

Can Drug-Induced Psychosis Have Lasting Effects?

Substance- or medication-induced psychotic disorder isn’t generally long-lasting if properly treated. Symptoms generally won’t last more than a few days once a person has detoxed from the relevant drug and received any treatments their doctor feels is appropriate. However, in some cases, notably with amphetamines, cocaine, and PCP, symptoms have been known to last multiple weeks.

While people who experience hallucinations or delusions aren’t generally dangerous to others, they do have the potential to act irrationally. Seeing, hearing, or believing things that aren’t real has the potential to do lasting harm if a person, for example, crashes a vehicle or forgets something important, like how a stove operates after turning it on. 

Schizophrenia

Some drugs have been known to trigger schizophrenia in people already at risk, even though they can’t directly cause schizophrenia if a person wasn’t already at risk due to other factors. What complicates this is that schizophrenia may have some very similar symptoms to substance-induced psychosis, but it isn’t the same. 

Schizophrenia is a lifelong condition, whereas substance-induced psychosis generally isn’t. However, both can generally be treated if properly diagnosed, greatly improving a person’s quality of life and reducing their symptoms.

How Is Drug-Induced Psychosis Treated?

Often, drug-induced psychosis is treated by bringing someone to a calm environment, where a treatment professional or group of professionals can make sure they don’t accidentally harm themselves or others as they recover. They may also be prescribed an anxiolytic, such as benzodiazepine, or an antipsychotic. 

If an individual struggles with drug use, they will also likely need to be treated for addiction because these psychotic episodes can recur if they continue to misuse drugs. The ideal addiction treatment will depend on the drugs they’re using and their unique needs, but it will usually involve detoxing at a rehab facility, a combination of therapy and counseling, and potentially the use of medication.

Is Psychosis Curable?

Psychosis is a set of symptoms that can be caused by a number of conditions, some more treatable than others. As noted earlier, schizophrenia can be the cause of a person’s psychosis, and that isn’t a curable condition. 

However, the symptoms associated with substance-induced psychotic episodes usually are curable, often resolving on their own in a few days (or less) if a person follows all instructions given to them by a medical professional.

If someone experiences psychotic symptoms while under the influence of a drug or after withdrawal from it, it’s important to get immediate medical attention. The treating professionals will attempt to determine the underlying cause of the psychotic symptoms. In most cases, they are a direct effect of the substance used, but in some cases, they may be linked to an underlying mental health disorder.

References

Substance-Induced Psychoses: An Updated Literature Review. (December 2021). Frontiers in Psychology.

Substance-/Medication-Induced Psychotic Disorder. (April 2022). Merck Manuals.

Causes – Schizophrenia. (November 2019). UK NHS.

Methamphetamine Psychosis: Epidemiology and Management. (December 2014). CNS Drugs.

Drug Abuse and Psychosis: New Insights into Drug-induced Psychosis. (February 2017). Experimental Neurobiology.