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Various psychoactive substances (both legal and illegal) have been implicated in causing, exacerbating, and/or precipitating psychotic states and/or disorders in users. This is also true of several medications that are not traditionally considered psychoactive drugs.
Psychotic states may occur after ingesting a variety of substances both legal and illegal and both prescription and non-prescription. Usually such states are temporary and not irreversible, with fluoroquinolone-induced psychosis being a notable exception. Drugs whose use, abuse or withdrawal are implicated include the following:
- F10.5 alcohol: Alcohol is a common risk of causing 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. Early studies have been criticized for failing to consider other drugs (such as LSD) that the participants may have used before or during the study, as well as other factors such as pre-existing ("comorbid") mental illness. However, more recent studies with better controls have still found an increase in risk for psychosis in cannabis users, albeit a more modest one. It is still not clear whether this is a causal link, and it is possible that cannabis use only increases the chance of psychosis in people already predisposed to it; or that people with developing psychosis use cannabis to provide temporary relief of their mental discomfort. Cannabis use has increased dramatically over past few decades but declined in the last decade, whereas the rate of psychosis has not increased. This suggests that a direct causal link is unlikely for all users.
- F13.5 sedatives/hypnotics (barbiturates; benzodiazepines): 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 (LSD and others)
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.
- Fluoroquinolone drugs, fluoroquinolone use has been linked to serious cases of toxic psychosis that have been reported to be irreversible and permanent, see Fluoroquinolone toxicity  The related quinoline derivative mefloquine (Lariam) has also been associated with psychosis.
- some over-the-counter drugs, including:
- prescription drugs:
- Synthetic research chemicals used recreationally, including:
- Volatile solvents and gases (inhalants)
- ↑ Larson, Michael Alcohol-Related Psychosis. eMedicine. WebMD. URL accessed on September 27, 2006.
- ↑ Soyka, Michael (March 1990). Psychopathological characteristics in alcohol hallucinosis and paranoid schizophrenia. Acta Psychiatrica Scandinavica 81 (3): 255–9.
- ↑ Gossman, William Delirium Tremens. eMedicine. WebMD. URL accessed on October 16, 2006.
- ↑ 4.0 4.1 http://emedicine.medscape.com/article/289848-overview Alcohol-Related Psychosis
- ↑ Tien AY, Anthony JC (August 1990). Epidemiological analysis of alcohol and drug use as risk factors for psychotic experiences. J. Nerv. Ment. Dis. 178 (8): 473–80.
- ↑ Cargiulo T (March 2007). Understanding the health impact of alcohol dependence. Am J Health Syst Pharm 64 (5 Suppl 3): S5–11.
- ↑ Schuckit MA (November 1983). Alcoholism and other psychiatric disorders. Hosp Community Psychiatry 34 (11): 1022–7.
- ↑ THC and Psychosis from Neuropsychopharmacology 35, 764–774, dated 1 February 2010.
- ↑ Cannabis and Psychosis from the British Medical Journal, dated 8 July 2005.
- ↑ Degenhardt L (January 2003). The link between cannabis use and psychosis: furthering the debate. Psychological Medicine 33 (1): 3–6.
- ↑ Moore TH, Zammit S, Lingford-Hughes A, et al. (July 2007). Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. Lancet 370 (9584): 319–28.
- ↑ Degenhardt L, Hall W, Lynskey M (2001). Comorbidity between cannabis use and psychosis: Modelling some possible relationships..
- ↑ de Paola L, Mäder MJ, Germiniani FM, et al. (June 2004). Bizarre behavior during intracarotid sodium amytal testing (Wada test): are they predictable?. Arquivos De Neuro-psiquiatria 62 (2B): 444–8.
- ↑ Sarrecchia C, Sordillo P, Conte G, Rocchi G (1998). [Barbiturate withdrawal syndrome: a case associated with the abuse of a headache medication]. Annali Italiani Di Medicina Interna 13 (4): 237–9.
- ↑ White MC, Silverman JJ, Harbison JW (February 1982). Psychosis associated with clonazepam therapy for blepharospasm. The Journal of Nervous and Mental Disease 170 (2): 117–9.
- ↑ Jaffe R, Gibson E (June 1986). Clonazepam withdrawal psychosis. Journal of Clinical Psychopharmacology 6 (3): 193.
- ↑ Hallberg RJ, Lessler K, Kane FJ (August 1964). Korsakoff-Like Psychosis Associated With Benzodiazepine Overdosage. The American Journal of Psychiatry 121: 188–9.
- ↑ Hall RC, Zisook S (1981). Paradoxical reactions to benzodiazepines. British Journal of Clinical Pharmacology 11 Suppl 1: 99S–104S.
- ↑ Lader M, Morton S. Benzodiazepine Problems. British Journal of Addiction 1991; 86: 823-828
- ↑ Benzodiazepines: Paradoxical Reactions & Long-Term Side-Effects
- ↑ Hansson O, Tonnby B. [Serious Psychological Symptoms Caused by Clonazepam.] Läkartidningen 1976; 73: 1210-1211.
- ↑ Pétursson H (November 1994). The benzodiazepine withdrawal syndrome. Addiction 89 (11): 1455–9.
- ↑ Brady, K. T., R. B. Lydiard, R. Malcolm, and J. C. Ballenger (December 1991). Cocaine-induced psychosis. Journal of Clinical Psychiatry 52 (12): 509–512.
- ↑ 24.0 24.1 24.2 Diaz, Jaime. How Drugs Influence Behavior. Englewood Cliffs: Prentice Hall, 1996.
- ↑ Hedges DW, Woon FL, Hoopes SP (March 2009). Caffeine-induced psychosis. CNS Spectrums 14 (3): 127–9.
- ↑ Cerimele JM, Stern AP, Jutras-Aswad D (March 2010). Psychosis following excessive ingestion of energy drinks in a patient with schizophrenia. The American Journal of Psychiatry 167 (3): 353.
- ↑ Cohen JS (December 2001). Peripheral Neuropathy Associated with Fluoroquinolones. Ann Pharmacother 35 (12): 1540–7.
- ↑ Adams M, Tavakoli H (2006). Gatifloxacin-induced hallucinations in a 19-year-old man. Psychosomatics 47 (4): 360.
- ↑ Mulhall JP, Bergmann LS (July 1995). Ciprofloxacin-induced acute psychosis. Urology 46 (1): 102–3.
- ↑ Reeves RR (1992). Ciprofloxacin-induced psychosis. Ann Pharmacother 26 (7-8): 930–1.
- ↑ Yasuda H, Yoshida A, Masuda Y, Fukayama M, Kita Y, Inamatsu T (March 1999). [Levofloxacin-induced neurological adverse effects such as convulsion, involuntary movement (tremor, myoclonus and chorea like), visual hallucination in two elderly patients]. Nippon Ronen Igakkai Zasshi 36 (3): 213–7.
- ↑ Azar S, Ramjiani A, Van Gerpen JA (April 2005). Ciprofloxacin-induced chorea. Mov. Disord. 20 (4): 513–4; author reply 514.
- ↑ Kukushkin ML, Igonkina SI, Guskova TA (April 2004). Mechanisms of pefloxacin-induced pain. Bull. Exp. Biol. Med. 137 (4): 336–8.
- ↑ Christie MJ, Wong K, Ting RH, Tam PY, Sikaneta TG (May 2005). Generalized seizure and toxic epidermal necrolysis following levofloxacin exposure. Ann Pharmacother 39 (5): 953–5.
- ↑ Marsepoil T, Petithory J, Faucher JM, Ho P, Viriot E, Benaiche F (1993). [Encephalopathy and memory disorders during treatments with mefloquine]. Rev Med Interne 14 (8): 788–91.
- ↑ Phillips-Howard PA, ter Kuile FO (June 1995). CNS adverse events associated with antimalarial agents. Fact or fiction?. Drug Saf 12 (6): 370–83.
- ↑ Price, Lawrence H., Jacqueline Lebel (September 2000). Dextromethorphan-Induced Psychosis. American Journal of Psychiatry 157 (2): 304.
- ↑ http://www.primarypsychiatry.com/aspx/articledetail.aspx?articleid=953 Deciphering a Psychosis: A Case of Dextromethorphan-Induced SymptomsLeonard Lachover, MD, based on Primary Psychiatry2007;14(1):70-72
- ↑ Sexton JD, Pronchik DJ (September 1997). Diphenhydramine-induced psychosis with therapeutic doses. The American Journal of Emergency Medicine 15 (5): 548–9.
- ↑ Lang, K., H. Sigusch, and S. Muller (December 8, 1995). [An anticholinergic syndrome with hallucinatory psychosis after diphenhydramine poisoning]. Deutsche medizinische Wochenschrift 120 (49): 1695–1698.
- ↑ Schreiber, W., A. M. Pauls and J. C. Kreig (February 5, 1988). [Toxic psychosis as an acute manifestation of diphenhydramine poisoning]. Deutsche medizinische Wochenschrift 113 (5): 180–183.
- ↑ Timnak, Charles, Ondria Gleason (January–February 2004). Promethazine-Induced Psychosis in a 16-Year-Old Girl. Psychosomatics 45 (1): 89–90.
- ↑ Official Journal of American Pediatrics - PEDIATRICS Vol. 108 No. 3 September 2001, p. e52
- ↑ PMID 438794 (PMID 438794)
- ↑ Bergman, K. R., C. Pearson, G. W. Waltz, and R. Evans III (December 1980). Atropine-induced psychosis. An unusual complication of therapy with inhaled atropine sulfate. Chest 78 (6): 891–893.
- ↑ Varghese, S., N. Vettath, K. Iyer, J. M. Puliyel, and M. M. Puliyel (June 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.
- ↑ Barak, Segev, Ina Weiner (September 13, 2006). Scopolamine Induces Disruption of Latent Inhibition Which is Prevented by Antipsychotic Drugs and an Acetylcholinesterase Inhibitor. Neuropsychopharmacology 32 (5): 989–99.
- ↑ Ettinger AB. "Psychotropic effects of antiepileptic drugs". Neurology. 12 December 2006;67(11):1916-25.
- ↑ http://www.erowid.org/references/refs_view.php?A=ShowDoc1&ID=526 'Ecstasy' Psychosis and Flashbacks F.J. CREIGHTON,D. L. BLACK and C. E. HYDE
- ↑ http://www.minddisorders.com/Py-Z/Substance-induced-psychotic-disorder.html Substance-induced psychotic disorder
- ↑ http://www.airforcetimes.com/news/2011/06/air-force-spice-users-risk-psychosis-says-doctor-061111w/ Spice users risk psychosis, doctor says By Gidget Fuentes - Staff writer Accessed 06-25-2011
- ↑ http://en.wikipedia.org/wiki/Synthetic_cannabis
- ↑ http://www.addictions.com/bath-salt-addiction Bath Salt Addiction, Accessed 06-25-2011
- ↑ Kurzbaum, Alberto, Claudia Simsolo, Ludmilla Kvasha and Arnon Blum (July 2001). Toxic Delirium due to Datura Stramonium. Israel Medical Association Journal 3 (7): 538–539.
- ↑ Przekop, Peter, Timothy Lee (July 2009). Persistent Psychosis Associated With Salvia Divinorum Use. American Journal of Psychiatry 166 (832): 832.
- ↑ Tarsh, M.J. (1979). Schizophreniform Psychosis caused by Sniffing Toluene. Journal of the Society for Occupational Medicine 1979 (29): 131–133.
- ↑ Rao, Naren P., Arun Gupta, K. Sreejayan, Prabhat K. Chand, Vivek Benegal, and Pratima Murthy (2009). Toluene associated schizophrenia-like psychosis. Indian Journal of Psychiatry 51 (4): 329–330.
- ↑ Jung IK, Lee HJ, Cho BH (December 2004). Persistent psychotic disorder in an adolescent with a past history of butane gas dependence. European Psychiatry 19 (8): 519–20.
- ↑ Hernandez-Avila, Carlos A., Hector A. Ortega-Soto, Antonio Jasso, Cecilia A. Hasfura-Buenaga, and Henry R. Kranzler (1998). Treatment of Inhalant-Induced Psychotic Disorder With Carbamazepine Versus Haloperidol. Psychiatric Services 49 (6): 812–815.
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