Substance-/Medication-Induced Psychotic Disorder

ByCarol Tamminga, MD, UT Southwestern Medical Dallas
Reviewed/Revised Apr 2022 | Modified Dec 2022
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Substance- or medication-induced psychotic disorder is characterized by hallucinations and/or delusions due to the direct effects of a substance or withdrawal from a substance in the absence of delirium.

Episodes of substance-induced psychosis are common in emergency departments and crisis centers. There are many precipitating substances, including alcohol, amphetamines, cannabis, , hallucinogens, opioids, phencyclidine (PCP), and sedative/hypnotics. To be considered substance-induced psychosis, the hallucinations and delusions should be in excess of those that typically accompany simple substance intoxication or withdrawal, although the patient may also be intoxicated or withdrawing.

(See also Introduction to Schizophrenia and Related Disorders.)

Treatment

  • A calm environment

  • Often a benzodiazepine or antipsychotic

In most substance-induced psychoses, stopping the substance and giving an anxiolytic (eg, a benzodiazepine) or antipsychotic drug is effective.

For psychosis due to drugs such as lysergic acid diethylamide (LSD), quiet observation may be all that is needed.

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