Drug-Induced Schizophrenia: Why Some Substances Can Trigger Psychiatric Symptoms
Key takeaways:
Schizophrenia is a serious mental health condition. It produces psychotic symptoms, like hallucination, delusions, and disorganized thoughts.
Certain substances can trigger psychotic symptoms. But they won’t produce a diagnosis of schizophrenia. To have a diagnosis of schizophrenia, a person’s symptoms cannot be caused by substance use.
Substance-induced psychotic disorders may vanish when you stop using the substance. Or the substance could produce symptoms that continue after you stop using it.
Alcohol and other drugs produce various effects during intoxication and withdrawal. Some substances can cause or worsen a psychotic episode and change the way you think, feel, and behave.
Drug-induced symptoms of schizophrenia are complex. They are challenging to identify and treat. Keep reading to learn more about substance-induced schizophrenia symptoms and how to help those in need.
What is schizophrenia?
Schizophrenia is a type of psychotic disorder. Like delusional disorder and schizoaffective disorder, schizophrenia can create psychotic symptoms. These may greatly disrupt your life and happiness.
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For most people, schizophrenia emerges sometime between their late teens and early 30s. There may be subtle signs that psychosis is building, or it could seem to happen all at once.
Common psychotic symptoms include:
Hallucinations: Your senses play tricks on you. You could see, feel, hear, smell, or taste things that are not really there.
Delusions: You believe something is true without any real proof or evidence. Delusions could involve paranoia or grand ideas.
Thinking problems: Your thinking patterns are strange, odd, or disorganized. You could struggle to continue a thought or a project you’re working on.
Movement problems: You could display and repeat abnormal or uncomfortable body movements.
What are the other symptoms of schizophrenia?
People with schizophrenia could also display negative and cognitive symptoms:
Negative symptoms: loss of motivation, energy, and interest in daily activities; pulling away from normal life; struggling to feel emotions
Cognitive symptoms: problems thinking clearly, focusing, and remembering things
Not every person with schizophrenia will display all of these signs. Many will have some combination of these symptoms, though.
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Since schizophrenia affects so much of your life in drastic ways, the condition can be challenging to manage. Anyone with symptoms of schizophrenia should seek out professional treatment as soon as possible. Getting treatment quickly can lead to much better outcomes long term.
What is drug-induced schizophrenia?
Drug-induced schizophrenia is an unofficial term that refers to symptoms of schizophrenia caused by substance use. You might see someone use drugs and begin showing the signs and symptoms of schizophrenia.
The drugs could make them:
Act in bizarre ways
Behave violently or aggressively
Become paranoid or overly confident
Have hallucinations
They could begin struggling in school, stop going to work, or cut off communication with loved ones. They could develop strange and unexpected beliefs and values.
The effects of the drugs may make it seem like they have schizophrenia. So you could think they have drug-induced schizophrenia. This is not really possible, though.
Is substance-induced schizophrenia diagnosable?
Based on the definition of schizophrenia, this mental health condition cannot be caused by any drug or substance use. If someone is having psychotic symptoms sparked by drug use, they could have substance-induced psychosis.
This condition may also be called:
Drug-induced psychosis
Medication-induced psychosis
Substance-induced psychotic disorder
The difference is small but important. The symptoms of schizophrenia and a substance-induced psychotic disorder may be similar or even the same, but the causes are different.
What’s the connection between schizophrenia and substance use?
The idea that substance use cannot cause schizophrenia may seem confusing. Experts believe that the same factors that put people at risk of schizophrenia also put them at risk of substance use disorders.
So many people with psychotic disorders use alcohol and other drugs. More than half of all people with a new psychotic disorder also have a substance use disorder.
People with schizophrenia may use any substance, but rates are higher for:
Alcohol
Cannabis (marijuana)
Tobacco
These substances do not cause schizophrenia, but they are connected to the condition.
What causes drug-induced schizophrenia symptoms?
As alcohol and other drugs enter the brain, they disrupt normal chemical functioning to produce their effects. Not all substances will create psychotic symptoms for all people.
The substances most frequently linked to substance-induced psychotic disorders are:
Cannabis (marijuana)
Amphetamine and methamphetamine
Cocaine
Hallucinogens are a class of substances that include LSD, ketamine, and psilocybin. These drugs create hallucinations and altered perceptions during intoxication. But, as the intoxication ends, the effects fade. Because of this, these substances are not usually linked to a diagnosis of drug-induced psychosis.
What other substances create drug-induced psychosis?
Other medications available over the counter and with a prescription can also cause symptoms of psychosis. Although the rates of psychosis are lower, the risk is still worth noting.
Medications linked to new psychosis in people are:
Antibiotics
Antihistamines
Corticosteroids
Heart medications, including beta blockers and ACE inhibitors
Pain relievers, including opioids (oxycodone, codeine) and some NSAIDs (ibuprofen)
Parkinson’s disease medications
If you or a loved one begins to notice symptoms of psychosis, speak with a medical professional immediately. In many cases, you can stop taking the medication to manage symptoms. In other situations, you may need to slowly reduce your dose to safely reduce symptoms.
How common is substance-induced psychosis?
Substance-induced symptoms of schizophrenia are more common than you may think. In fact, depending on the substance, rates can be very high.
Studies have found that:
As many as 10% of cannabis (marijuana) users will experience psychotic symptoms at some point.
As many as 87% of people who use cocaine will have psychotic symptoms. Of those, most (90%) will experience paranoid delusions. And even more (96%) will have some type of hallucinations.
Almost 15% of amphetamine users and more than 11% of methamphetamine users report psychotic symptoms.
How long will schizophrenia-like symptoms caused by drugs last?
In the best cases, the schizophrenia-like symptoms caused by drugs will be mild and short lived. As the body processes the substances, many people will see the symptoms fade in the hours and days after last use.
Other people will see symptoms continue for weeks, months, or longer. One study of psychotic symptoms among methamphetamine users in China found that:
60% of participants had symptoms end in less than 30 days.
30% reported that symptoms ended between 1 and 6 months after last use.
10% noted symptoms for at least 6 months.
If you continue using substances, the symptoms will likely continue or return. The best hope for ending the unwanted psychotic symptoms is to end all use.
Who’s most at risk of drug-induced schizophrenia?
Anyone using over-the-counter, prescription, or illicit substances has some risk of psychotic symptoms. It seems that the group at greatest risk are people misusing stimulants. Cocaine, amphetamines, and methamphetamine all produced higher rates of psychosis than other substances. People with a family history of mental illness, earlier age of starting substance use, and longer periods of substance use are also at greater risk.
The bottom line
Substances cannot cause schizophrenia, but they can produce symptoms that look similar to the condition. Whether they’re caused by substances or not, you should contact your healthcare provider if you experience psychotic symptoms. Only with a proper diagnosis can you get the best treatment.
Why trust our experts?
If you or someone you know struggles with substance use, help is available. Call SAMHSA’s National Helpline at 1-800-662-HELP (4357) to learn about resources in your area.
For additional resources or to connect with mental health services in your area, call the NAMI HelpLine at 1-800-950-NAMI (6264). For immediate assistance, call the National Suicide Prevention Lifeline at 1-800-273-8255.
References
Ambizas, E. M. (2014). Nonpsychotropic medication-induced psychosis. U.S. Pharmacist.
Deng, X., et al. (2012). Long-term follow-up of patients treated for psychotic symptoms that persist after stopping illicit drug use. Shanghai Archives of Psychiatry.
Fiorentini, A., et al. (2021). Substance-induced psychoses: An updated literature review. Frontiers in Psychiatry.
Mills, K., et al. (2011). Psychosis and substance use. National Drug and Alcohol Research Centre.
National Institute of Mental Health. (2022). Schizophrenia.
Substance Abuse and Mental Health Services Administration. (2019). First episode psychosis and co-occurring substance use disorders.
