Psychotic disorder caused by taking psychoactive substances
Last reviewed: 23.04.2024
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Psychotic symptoms, especially delirium and hallucinations, can result from a wide range of substances, including alcohol, amphetamines, marijuana, cocaine, hallucinogens, inhalants, opioids, phencyclidine, some sedatives and anxiolytics. The diagnosis is established if the symptoms begin within 1 month or less after intoxication or withdrawal of the substance involved and after exclusion of other psychotic disorders. Since the symptoms may coincide with the symptoms of transient psychotic disorder, schizophreniform disorder, acute episodes of mania or schizophrenia, the difference between these states can be difficult. Diagnosis may require several days of follow-up. Treatment may vary depending on the substance involved. Hallucinogenic and phencyclidine psychoses may not respond in the proper way to the appointment of antipsychotics. A supportive approach is preferred with an encouraging, structured and protective environment. Agitation is best ameliorated by the administration of short-acting benzodiazepines, such as lorazepam, administered orally or intramuscularly.
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