Substance-induced psychosis is a form of substance use disorder where psychosis
can be attributed to substance use. It is a psychosis that results from the
poisonous effects of chemicals or drugs, including those produced by the body
itself. Various psychoactive substances have been implicated in causing or
worsening psychosis in users. Effects of Psychosis
Psychosis manifests as disorientation and visual hallucinations. It is a state
in which a person's mental capacity to recognize reality, communicate, and
relate to others is impaired, thus interfering with the capacity to deal
with life demands. While there are many types of psychosis, substance-induced
psychosis can be pinpointed to specific chemicals.
Substances Psychotic states may occur after using a
variety of legal and illegal substances. Usually such states are temporary and
reversible, with fluoroquinolone-induced psychosis being a notable exception.
Drugs whose use, abuse, or withdrawal are implicated in psychosis include the
following: = ICD-10=
F10.5 alcohol: Alcohol is a common cause of psychotic disorders or episodes,
which may occur through acute intoxication, chronic alcoholism,
withdrawal, exacerbation of existing disorders, or acute idiosyncratic
reactions. Research has shown that alcohol abuse causes an 8-fold increased
risk of psychotic disorders in men and a 3 fold increased risk of psychotic
disorders in women. While the vast majority of cases are acute and resolve
fairly quickly upon treatment and/or abstinence, they can occasionally become
chronic and persistent. Alcoholic psychosis is sometimes misdiagnosed as
another mental illness such as schizophrenia.
F12.5 cannabinoid: Some studies indicate that cannabis, especially certain
strains containing large proportions of THC and low proportions of CBD, may
lower the threshold for psychosis, and thus help to trigger full-blown
psychosis in some people. Recent studies have found an increase in risk for
psychosis in cannabis users. It is not clear whether this is a causal link; it
is possible that cannabis use only increases the risk of psychosis in
people already predisposed to it. F13.5 sedatives/hypnotics: It is also
important to this topic to understand the paradoxical effects of some sedative
drugs. Serious complications can occur in conjunction with the use of sedatives
creating the opposite effect as to that intended. Malcolm Lader at the Institute
of Psychiatry in London estimates the incidence of these adverse reactions at
about 5%, even in short-term use of the drugs. The paradoxical reactions may
consist of depression, with or without suicidal tendencies, phobias,
aggressiveness, violent behavior and symptoms sometimes misdiagnosed as
psychosis. However, psychosis is more commonly related to the benzodiazepine
withdrawal syndrome. F14.5 cocaine
F15.5 other stimulants: amphetamines; methamphetamine; methylphenidate. See
also stimulant psychosis. F16.5 hallucinogens
The code F11.5 is reserved for opioid-induced psychosis, and F17.5 is
reserved for tobacco-induced psychosis, but neither substance is traditionally
associated with the induction of psychosis.
The code F15.5 also includes caffeine-induced psychosis, despite not
being specifically listed in the DSM-IV. However, there is evidence that
caffeine, in extreme acute doses or when severely abused for long periods of
time, may induce psychosis. = Other=
Fluoroquinolone drugs, fluoroquinolone use has been linked to serious cases of
toxic psychosis that have been reported to be irreversible and permanent, see
adverse effects of fluoroquinolones The related quinoline derivative mefloquine
has also been associated with psychosis. some over-the-counter drugs, including:
Dextromethorphan at high doses. Certain antihistamines at high doses.
Cold Medications prescription drugs:
Prednisone and other corticosteroids Isotretinoin
Anticholinergic drugs atropine
scopolamine antidepressants
L-dopa antiepileptics
antipsychotics, in an idiosyncratic reaction
Other illegal drugs, including: MDMA
Phencyclidine Ketamine
Synthetic research chemicals used recreationally, including:
JWH-018 and some other synthetic cannabinoids, or mixtures containing
them. Various "JWH-XXX" compounds in "Spice" or "Incense" have also been
found and have been found to cause psychosis in some people.
Mephedrone and related amphetamine-like drugs sold as "bath salts" or "plant
food". Plants
Hawaiian baby woodrose Morning glory seeds
Jimson weed Belladonna
Salvia divinorum Volatile solvents and gases
Toluene, found in glue, paint, thinner, etc. See also toluene toxicity.
Butane Gasoline,
References