Drug-induced schizophrenia (drug-induced psychosis)

What is drug-induced psychosis? 

The condition some people refer to as drug-induced schizophrenia is actually drug-induced psychosis. A person develops this kind of psychosis because of the effects of drugs on the brain.

Psychosis is a disconnection from reality that causes a person to experience delusions, where they believe untrue things, or hallucinations, where they experience things that are not there.

Drug-induced psychosis vs. schizophrenia

Drug-induced psychosis is not schizophrenia, so the term drug-induced schizophrenia is a misnomer.

The symptoms of drug-induced psychosis are almost identical toTrusted Source those of schizophrenia. The difference between the two conditions is that schizophrenia lasts longer than 6 monthsTrusted Source. Additionally, for a schizophrenia diagnosis, drugs must not cause a person’s symptoms.

However, if a person with schizophrenia also misuses substances this can make it difficult to distinguish between drug-induced psychosis and underlying schizophrenia in a person with a substance use disorder.

Research also suggests that, in some people, drugs may triggerTrusted Source schizophrenia, or a drug-induced psychotic episode may precede a schizophrenia diagnosis. For example, a 2016 review of research showed that 17% of people who initially received a diagnosis of drug-induced psychosis later progressed to having schizophrenia.

Causes of drug-induced psychosis

Any drug that changes how a person thinks or behaves or causes a person to become high may trigger psychosis. Some research suggests the risk is higherTrusted Source with larger doses or prolonged use.

Drugs can change levels of neurotransmitters in the brain, causing the brain to process information in atypical ways. This also occursTrusted Source in schizophrenia.

Some drugs that may cause psychosis either during use or withdrawal from use include:

• alcohol
• sedatives
• illegal drugs such as
  • cocaine
  • methamphetamines
  • heroin
  • cannabis
  • phencyclidine, or PCP
  • hallucinogens such as LSD

Symptoms of drug-induced psychosis

If someone experiences delusions or hallucinations following drug use without any other cause for these symptoms, they may meet the criteria for drug-induced psychosis.

A healthcare professional will likely not give a diagnosis of substance-induced psychotic disorder unless the disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Symptoms of psychosis include:

• Delusions: This means a person believes things that are demonstrably untrue or very likely to be untrue. They might believe they are a god or that a government entity is pursuing them.
• Hallucinations: A person having hallucinations experiences things that are not there or that other people do not experience. They might hear voices, see things other people do not see, or report smelling things others do not.
• Unusual behavior: People experiencing psychosis often demonstrate unusual behavior based on their delusions and hallucinations. They might appear paranoid, aggressive, or withdrawn.
• Changes in thinking: Psychosis often causes people to have unusual thoughts or resist evidence that their symptoms indicate psychosis.

Diagnosis

No test can conclusively diagnose drug-induced psychosis, though drug tests may confirm that a person is under the influence of drugs.

Instead, doctors diagnose the condition based on symptoms. Then, to confirm the diagnosis of drug-induced psychosis, they have a person stop using drugs.

If symptoms disappear, then the psychosis is drug-induced. If they do not, a person may have schizophrenia or another psychotic disorder.

Treatment and recovery 

In most cases, symptoms of drug-induced psychosis resolve quickly on their own, with or without treatment. When the drug leaves a person’s body, they generally regain their connection to reality.

However, cocaine, PCP, and amphetamines may cause longer-lasting symptoms that take several weeks to go away. In these cases, it can take weeks to determine whether the psychosis is drug-induced.

Medications

Some medications may help a person recover faster from drug-induced psychosis. Benzodiazepines and antipsychotics may be effective, but the right drug will depend on the drug that triggered the psychosis. Drugs that stimulate dopamine, such as amphetamines, often respond better to antipsychotics.

Antipsychotics are alsoTrusted Source one of the main treatments for schizophrenia, so they may help with psychosis in a person with schizophrenia who engages in drug misuse. If symptoms return after a person stops taking antipsychotic medication, and the person continues to experience symptoms in the absence of drug use, they may have schizophrenia rather than drug-induced psychosis.

When to contact a doctor

A person should contact a doctor if they experience symptoms of psychosis, no matter what the trigger is. Some signs to look for include:

• suddenly seeing, hearing, or experiencing things others do not
• believing things others think are untrue
• a change in perceptions, behavior, or experience, especially after drug use
• paranoia or anxiety because of beliefs or experiences other people do not share

A person should also contact a doctor if their symptoms come back after they stop taking antipsychotics or if they experience side effects with drugs for psychosis.

Outlook 

The outlook for people with drug-induced psychosis is good. Symptoms usually go away after a person stops using the drug. This often happens within a few hours, but improvement may take several weeks in the case of drugs such as amphetamines, PCP, and cocaine. This is likely with chronic use.

Schizophrenia isTrusted Source a chronic illness. There is currently no cure, but treatment can improve symptoms. Access to quality medical care is important. The outlook is generally better for females, people living in wealthy nations, and those who developed schizophrenia in adulthood.

However, the side effects of schizophrenia medication can be difficult to manage, and it is common for people to stop taking their medication. Suicide remains a leading cause of death in people with schizophrenia.

The life expectancy for people with schizophrenia is lower than that of the general population, though estimates of how schizophrenia affects life expectancy vary.

Summary 

Drug-induced psychosis is not schizophrenia and usually goes away on its own with or without treatment if a person stops using the drug that caused it.

However, a psychotic episode under the influence of drugs may be an early warning sign of schizophrenia or a trigger for schizophrenia in people who may be more likely to develop the condition.

Getting treatment for psychotic symptoms can help a person get the right care and reduce the risk that symptoms will negatively affect their life.

A person experiencing any signs of psychosis should contact a doctor or mental health professional. If the symptoms are severe or cause a person to contemplate harming themselves or others, they should seek emergency care.