Medicine:Substance-induced psychosis

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Substance-induced psychosis
Other namesSubstance-induced psychotic disorder, drug-induced psychosis, substance/medication-induced psychotic disorder, toxic psychosis
SpecialtyPsychiatry, addiction psychiatry

Substance-induced psychosis (commonly known as toxic psychosis or drug-induced psychosis) is a form of psychosis that is attributed to substance intoxication. It is a psychosis that results from the effects of chemicals or drugs. Various psychoactive substances have been implicated in causing or worsening psychosis in users.

Signs and symptoms

Main page: Medicine:Psychosis

Psychosis manifests as disorientation, visual hallucinations and/or haptic hallucinations.[1] 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's demands.[2] While there are many types of psychosis, the cause of substance-induced psychosis can be pinpointed to intake of specific chemicals.

Substance use and schizophrenia

Rates of drug use amongst people with schizophrenia are higher than the general population; 50% of those diagnosed with schizophrenia use substances over their life.[3](pp495,496) There is a model that suggests this arises because those with schizophrenia self-medicate with psychoactive drugs.[3](p500)

Transition to schizophrenia

A 2019 systematic review and meta-analysis found that the Template:Estimate of people diagnosed with substance-induced psychosis went on to be diagnosed with schizophrenia, compared with Template:Estimate for brief, atypical and not otherwise specified psychoses.[4] The substance present was the primary predictor of transition from drug-induced psychosis to schizophrenia, with highest rates associated with cannabis (Template:Estimate), hallucinogens (Template:Estimate) and amphetamines (Template:Estimate). Lower rates were reported for opioid– (Template:Estimate), alcohol– (Template:Estimate) and sedative– (Template:Estimate) induced psychoses. Transition rates were slightly lower in older cohorts but were not affected by sex, country of the study, hospital or community location, urban or rural setting, diagnostic methods, or duration of follow-up.[4]

Class of substance Number of studies Rates of transition to schizophrenia
Estimate Lower bound Upper bound
Brief, atypical and NOS 34 36% 30% 43%
Combined - 25% 18% 38%
Cannabis 6 34% 25% 46%
Hallucinogens 3 26% 14% 43%
Amphetamines 5 22% 14% 34%
Opioid 3 12% 8% 18%
Sedative 3 10% 7% 15%
Alcohol 5 9% 6% 15%

Substances

Psychotic states may occur after using a variety of legal and illegal substances. Substances whose use or withdrawal is implicated in psychosis include the following:

International Classification of Diseases

Psychoactive substance-induced psychotic disorders outlined within the ICD-10 codes F10.5—F19.5:

  • F10.5 alcohol:[5][6][7] 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.[5] Research has shown that excessive alcohol use causes an 8-fold increased risk of psychotic disorders in men and a 3 fold increased risk of psychotic disorders in women.[8][9] While the vast majority of cases are acute and resolve fairly quickly upon treatment and/or abstinence, they can occasionally become chronic and persistent.[5] Alcoholic psychosis is sometimes misdiagnosed as another mental illness such as schizophrenia.[10]
  • F11.5 opioid: Studies show stronger opioids such as fentanyl are more likely to cause psychosis and hallucinations[11]
  • F12.5 cannabinoid: Some studies indicate that cannabis may trigger full-blown psychosis.[12] Recent studies have found an increase in risk for psychosis in cannabis users.[13]
  • F13.5 sedatives/hypnotics (barbiturates;[14][15] benzodiazepines):[16][17][18] It is also important to this topic to understand the paradoxical effects of some sedative drugs.[19] 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.[20] The paradoxical reactions may consist of depression, with or without suicidal tendencies, phobias, aggressiveness, violent behavior and symptoms sometimes misdiagnosed as psychosis.[21][22] However, psychosis is more commonly related to the benzodiazepine withdrawal syndrome.[23]
  • F14.5 cocaine[24]
  • F15.5 other stimulants: amphetamines,[25][pages needed] methamphetamine,[25] and methylphenidate,[25] among others (see also Stimulant psychosis).
  • F16.5 hallucinogens (LSD and others)
  • F18.5 volatile solvents (volatile inhalants);[26]

F17.5 is reserved for tobacco-induced psychosis, but is traditionally not 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 taken in excess for long periods of time, may induce psychosis.[31][32]

Medication

Other drugs illicit in America

Other drugs illegal in America (not listed above), including:

  • MDMA (ecstasy)[59]
  • Phencyclidine (PCP)[60][61]
  • Synthetic research chemicals used recreationally, including:
  • JWH-018 and some other synthetic cannabinoids, or mixtures containing them (e.g. "Spice", "Kronic", "MNG" or "Mr. Nice Guy", "Relaxinol", etc.).[62] Various "JWH-..." compounds in "Spice" or "Incense" have also been found and have been found to cause psychosis in some people.[63][64][65]
  • Mephedrone and related amphetamine-like drugs sold as "bath salts" or "plant food".[66]

Plants

Plants:

Nonmedicinal substances

Substances chiefly nonmedicinal as to source:

See also

References

  1. ↑ Pitts, Ferris N; Allen, Robert E; Aniline, Orm; Burgoyne, Rodney W (August 1982). "The Dilemma of the Toxic Psychosis: Differential Diagnosis and the PCP Psychosis". Psychiatric Annals 12 (8): 762–8. doi:10.3928/0048-5713-19820801-07. OCLC 5584879101. 
  2. ↑ "toxic psychosis". TheFreeDictionary.com. http://medical-dictionary.thefreedictionary.com/toxic+psychosis. 
  3. ↑ 3.0 3.1 Gregg, Lynsey; Barrowclough, Christine; Haddock, Gillian (2007-05-01). "Reasons for increased substance use in psychosis" (in en). Clinical Psychology Review 27 (4): 494–510. doi:10.1016/j.cpr.2006.09.004. ISSN 0272-7358. PMID 17240501. https://www.sciencedirect.com/science/article/pii/S0272735806001140. 
  4. ↑ 4.0 4.1 Murrie, Benjamin; Lappin, Julia; Large, Matthew; Sara, Grant (16 October 2019). "Transition of Substance-Induced, Brief, and Atypical Psychoses to Schizophrenia: A Systematic Review and Meta-analysis". Schizophrenia Bulletin 46 (3): 505–516. doi:10.1093/schbul/sbz102. PMID 31618428. 
  5. ↑ 5.0 5.1 5.2 Alcohol-Related Psychosis at eMedicine
  6. ↑ Soyka, Michael (March 1990). "Psychopathological characteristics in alcohol hallucinosis and paranoid schizophrenia". Acta Psychiatrica Scandinavica 81 (3): 255–9. doi:10.1111/j.1600-0447.1990.tb06491.x. PMID 2343749. 
  7. ↑ Delirium Tremens (DTs) at eMedicine
  8. ↑ Tien, Allen Y.; Anthony, James C. (August 1990). "Epidemiological Analysis of Alcohol and Drug Use as Risk Factors for Psychotic Experiences". The Journal of Nervous and Mental Disease 178 (8): 473–480. doi:10.1097/00005053-199017880-00001. PMID 2380692. 
  9. ↑ Cargiulo, Thomas (1 March 2007). "Understanding the health impact of alcohol dependence". American Journal of Health-System Pharmacy 64 (5 Supplement 3): S5–S11. doi:10.2146/ajhp060647. PMID 17322182. 
  10. ↑ Schuckit, Marc A. (November 1983). "Alcoholism and Other Psychiatric Disorders". Psychiatric Services 34 (11): 1022–1027. doi:10.1176/ps.34.11.1022. PMID 6642446. 
  11. ↑ Sivanesan, Eellan; Gitlin, Melvin C.; Candiotti, Keith A. (October 2016). "Opioid-induced Hallucinations". Anesthesia & Analgesia 123 (4): 836–843. doi:10.1213/ANE.0000000000001417. PMID 27258073. 
  12. ↑ Degenhardt L (January 2003). "The link between cannabis use and psychosis: furthering the debate". Psychological Medicine 33 (1): 3–6. doi:10.1017/S0033291702007080. PMID 12537030. 
  13. ↑ "Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review". Lancet 370 (9584): 319–28. July 2007. doi:10.1016/S0140-6736(07)61162-3. PMID 17662880. http://orca.cf.ac.uk/619/1/Appendix%201%20%28search%20strategy%29%20Cannabis%20use%20and%20risk%20of%20developing%20psychotic%20or%20affective%20mental%20health%20outcomes%20a%20systematic%20review.pdf. 
  14. ↑ "Bizarre behavior during intracarotid sodium amytal testing (Wada test): are they predictable?". Arquivos de Neuro-Psiquiatria 62 (2B): 444–8. June 2004. doi:10.1590/S0004-282X2004000300012. PMID 15273841. 
  15. ↑ "[Barbiturate withdrawal syndrome: a case associated with the abuse of a headache medication]" (in it). Annali Italiani di Medicina Interna 13 (4): 237–9. 1998. PMID 10349206. 
  16. ↑ "Psychosis associated with clonazepam therapy for blepharospasm". The Journal of Nervous and Mental Disease 170 (2): 117–9. February 1982. doi:10.1097/00005053-198202000-00010. PMID 7057171. 
  17. ↑ "Clonazepam withdrawal psychosis". Journal of Clinical Psychopharmacology 6 (3): 193. June 1986. doi:10.1097/00004714-198606000-00021. PMID 3711371. 
  18. ↑ "Korsakoff-Like Psychosis Associated With Benzodiazepine Overdosage". The American Journal of Psychiatry 121 (2): 188–9. August 1964. doi:10.1176/ajp.121.2.188. PMID 14194223. 
  19. ↑ "Paradoxical reactions to benzodiazepines". British Journal of Clinical Pharmacology 11 (Suppl 1): 99S–104S. 1981. doi:10.1111/j.1365-2125.1981.tb01844.x. PMID 6133541. 
  20. ↑ "Benzodiazepine Problems". British Journal of Addiction 86 (7): 823–828. 1991. doi:10.1111/j.1360-0443.1991.tb01831.x. PMID 1680514. 
  21. ↑ Benzodiazepines: Paradoxical Reactions & Long-Term Side-Effects
  22. ↑ "Serious Psychological Symptoms Caused by Clonazepam". Läkartidningen 73 (13): 1210–1211. 1976. PMID 1263638. 
  23. ↑ Pétursson H (November 1994). "The benzodiazepine withdrawal syndrome". Addiction 89 (11): 1455–9. doi:10.1111/j.1360-0443.1994.tb03743.x. PMID 7841856. 
  24. ↑ Brady, K. T.; R. B. Lydiard; R. Malcolm; J. C. Ballenger (December 1991). "Cocaine-induced psychosis". Journal of Clinical Psychiatry 52 (12): 509–512. PMID 1752853. 
  25. ↑ 25.0 25.1 25.2 Diaz, Jaime. How Drugs Influence Behavior. Englewood Cliffs: Prentice Hall, 1996.
  26. ↑ "揮発性溶剤誘発性精神病の症候学的構造 「溶剤性精神病」は識別可能な症候群か?" (in ja). 日本アルコール・薬物医学会雑誌 = [Japanese Journal of Alcohol Studies & Drug Dependence] 40 (5): 471–484. 2005. PMID 16316074. https://www.jstage.jst.go.jp/article/fpj/117/1/117_1_42/_pdf. 
  27. ↑ Tarsh, M.J. (1979). "Schizophreniform Psychosis caused by Sniffing Toluene". Occupational Medicine 29 (4): 131–133. doi:10.1093/occmed/29.4.131. PMID 513663. 
  28. ↑ Rao, Naren P.; Arun Gupta; K. Sreejayan; Prabhat K. Chand; Vivek Benegal; Pratima Murthy (2009). "Toluene associated schizophrenia-like psychosis". Indian Journal of Psychiatry 51 (4): 329–330. doi:10.4103/0019-5545.58307. PMID 20048466. 
  29. ↑ "Persistent psychotic disorder in an adolescent with a past history of butane gas dependence". European Psychiatry 19 (8): 519–20. December 2004. doi:10.1016/j.eurpsy.2004.09.010. PMID 15589716. 
  30. ↑ Hernandez-Avila, Carlos A.; Hector A. Ortega-Soto; Antonio Jasso; Cecilia A. Hasfura-Buenaga; Henry R. Kranzler (1998). "Treatment of Inhalant-Induced Psychotic Disorder With Carbamazepine Versus Haloperidol". Psychiatric Services 49 (6): 812–815. doi:10.1176/ps.49.6.812. PMID 9634163. 
  31. ↑ "Caffeine-induced psychosis". CNS Spectrums 14 (3): 127–9. March 2009. doi:10.1017/S1092852900020101. PMID 19407709. 
  32. ↑ "Psychosis following excessive ingestion of energy drinks in a patient with schizophrenia". The American Journal of Psychiatry 167 (3): 353. March 2010. doi:10.1176/appi.ajp.2009.09101456. PMID 20194494. 
  33. ↑ Cohen JS (December 2001). "Peripheral Neuropathy Associated with Fluoroquinolones". Ann Pharmacother 35 (12): 1540–7. doi:10.1345/aph.1Z429. PMID 11793615. http://fqvictims.org/fqvictims/News/neuropathy/Neuropathy.pdf. 
  34. ↑ "Gatifloxacin-induced hallucinations in a 19-year-old man". Psychosomatics 47 (4): 360. 2006. doi:10.1176/appi.psy.47.4.360. PMID 16844899. https://zenodo.org/record/1236206. 
  35. ↑ "Ciprofloxacin-induced acute psychosis". Urology 46 (1): 102–3. July 1995. doi:10.1016/S0090-4295(99)80171-X. PMID 7604468. 
  36. ↑ Reeves RR (1992). "Ciprofloxacin-induced psychosis". Ann Pharmacother 26 (7–8): 930–1. doi:10.1177/106002809202600716. PMID 1504404. 
  37. ↑ "Levofloxacin-Induced Neurological Adverse Effects such as Convulsion, Involuntary Movement (Tremor, Myoclonus and Chorea Like), Visual Hallucination in Two Elderly Patients" (in ja). Nippon Ronen Igakkai Zasshi 36 (3): 213–7. March 1999. doi:10.3143/geriatrics.36.213. PMID 10388331. 
  38. ↑ "Ciprofloxacin-induced chorea". Mov. Disord. 20 (4): 513–4; author reply 514. April 2005. doi:10.1002/mds.20425. PMID 15739219. 
  39. ↑ "Mechanisms of pefloxacin-induced pain". Bull. Exp. Biol. Med. 137 (4): 336–8. April 2004. doi:10.1023/B:BEBM.0000035122.45148.93. PMID 15452594. 
  40. ↑ "Generalized seizure and toxic epidermal necrolysis following levofloxacin exposure". Ann Pharmacother 39 (5): 953–5. May 2005. doi:10.1345/aph.1E587. PMID 15827068. 
  41. ↑ "[Encephalopathy and memory disorders during treatments with mefloquine]" (in fr). Rev Méd Interne 14 (8): 788–91. 1993. doi:10.1016/S0248-8663(05)81426-2. PMID 8191092. 
  42. ↑ "CNS adverse events associated with antimalarial agents. Fact or fiction?". Drug Saf 12 (6): 370–83. June 1995. doi:10.2165/00002018-199512060-00003. PMID 8527012. 
  43. ↑ Price, L. H.; Lebel, J (1 February 2000). "Dextromethorphan-Induced Psychosis". American Journal of Psychiatry 157 (2): 304. doi:10.1176/appi.ajp.157.2.304. PMID 10671422. 
  44. ↑ Lachover, L. (2007). "Deciphering a Psychosis: A Case of Dextromethorphan-Induced Symptoms". Primary Psychiatry 14 (1): 70–72. http://www.primarypsychiatry.com/aspx/articledetail.aspx?articleid=953. 
  45. ↑ Sexton, J. D.; Pronchik, D. J. (1997). "Diphenhydramine-induced psychosis with therapeutic doses". The American Journal of Emergency Medicine 15 (5): 548–549. doi:10.1016/S0735-6757(97)90212-6. PMID 9270406. 
  46. ↑ Lang, K.; Sigusch, H.; Müller, S. (1995). "Anticholinergisches Syndrom mit halluzinatorischer Psychose nach Diphenhydramin-Intoxikation" (in de). Deutsche Medizinische Wochenschrift 120 (49): 1695–1698. doi:10.1055/s-2008-1055530. PMID 7497894. 
  47. ↑ Schreiber, W.; Pauls, A. M.; Krieg, J. C. (1988). "Toxische Psychose als Akutmanifestation der Diphenhydraminvergiftung" (in de). Deutsche Medizinische Wochenschrift 113 (5): 180–183. doi:10.1055/s-2008-1067616. PMID 3338401. 
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  49. ↑ Gunn, V. L.; Taha, S. H.; Liebelt, E. L.; Serwint, J. R. (1 September 2001). "Toxicity of Over-the-Counter Cough and Cold Medications". Pediatrics 108 (3): e52. doi:10.1542/peds.108.3.e52. PMID 11533370. 
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  53. ↑ Varghese, S.; Vettath, N.; Iyer, K.; Puliyel, J. M.; Puliyel, M. M. (1990). "Ocular atropine induced psychosis--is there a direct access route to the brain?". Journal of the Association of Physicians of India 38 (6): 444–445. PMID 2384469. 
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  58. ↑ Perk, David (2018). "Mepacrine Psychosis". Journal of Mental Science 93 (393): 756–771. doi:10.1192/bjp.93.393.756. ISSN 0368-315X. PMID 18916870. 
  59. ↑ Creighton, FJ; Black, DL; Hyde, CE (November 1991). "'Ecstasy' psychosis and flashbacks". Br J Psychiatry 159 (5): 713–5. doi:10.1192/bjp.159.5.713. PMID 1684523. http://www.erowid.org/references/refs_view.php?A=ShowDoc1&ID=526. 
  60. ↑ Substance-induced psychotic disorder www.minddisorders.com
  61. ↑ Wright, H. H.; Cole, E. A.; Batey, S. R.; Hanna, K. (May 1988). "Phencyclidine-induced psychosis: eight-year follow-up of ten cases". Southern Medical Journal 81 (5): 565–567. doi:10.1097/00007611-198805000-00005. ISSN 0038-4348. PMID 3368805. https://pubmed.ncbi.nlm.nih.gov/3368805/. 
  62. ↑ Spice users risk psychosis, doctor says Gidget Fuentes - Staff writer Accessed 06-25-2011 www.airforcetimes.com [yes|permanent dead link|dead link}}]
  63. ↑ Shalit, Nadav; Barzilay, Ran; Shoval, Gal; Shlosberg, Dan; Mor, Nofar; Zweigenhaft, Nofar; Weizman, Abraham; Krivoy, Amir (24 August 2016). "Characteristics of Synthetic Cannabinoid and Cannabis Users Admitted to a Psychiatric Hospital". The Journal of Clinical Psychiatry 77 (8): e989–e995. doi:10.4088/JCP.15m09938. PMID 27379411. 
  64. ↑ Every-Palmer S (2010). "Warning: legal synthetic cannabinoid-receptor agonists such as JWH-018 may precipitate psychosis in vulnerable individuals". Addiction 105 (10): 1859–60. doi:10.1111/j.1360-0443.2010.03119.x. PMID 20840203. 
  65. ↑ "The synthetic cannabinoid Spice as a trigger for an acute exacerbation of cannabis induced recurrent psychotic episodes". Schizophr. Res. 118 (1–3): 309–10. 2010. doi:10.1016/j.schres.2009.12.001. PMID 20056392. 
  66. ↑ Bath Salt Addiction, www.addictions.com, Accessed 06-25-2011
  67. ↑ Kurzbaum, Alberto; Claudia Simsolo; Ludmilla Kvasha; Arnon Blum (July 2001). "Toxic Delirium due to Datura Stramonium". Israel Medical Association Journal 3 (7): 538–539. PMID 11791426. http://www.ima.org.il/imaj/ar01jul-16.pdf. Retrieved 2006-10-17. 
  68. ↑ Przekop, Peter; Lee, Timothy (July 2009). "Persistent Psychosis Associated With Salvia Divinorum Use". American Journal of Psychiatry 166 (7): 832. doi:10.1176/appi.ajp.2009.08121759. PMID 19570943. 
  69. ↑ 69.0 69.1 69.2 69.3 American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Arlington, VA: American Psychiatric Publishing. p. 113. doi:10.1176/appi.books.9780890425596. ISBN 978-0-89042-554-1. https://archive.org/details/diagnosticstatis0005unse/page/113. 

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