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Substance-induced psychosis
Classification and external resources
ICD-10 F10.5-F19.5
ICD-9 292.1
MeSH D011605

Substance-induced psychosis is a form of substance-related disorder where psychosis can be attributed to substance use. Various psychoactive substances have been implicated in precipitating, exacerbating, or causing psychosis in users. Some individuals with substance-induced psychosis with insight, who believe that their abuse of substances caused their psychosis, may have suicidal thinking as a result.


Psychotic states may occur after using a variety of legal and illegal substances. Usually such states are temporary and not irreversible, with fluoroquinolone-induced psychosis being a notable exception. Drugs whose use, abuse, or withdrawal are implicated in psychosis include the following:


  • F10.5 alcohol:[1][2][3] 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.[4] 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.[5][6] While the vast majority of cases are acute and resolve fairly quickly upon treatment and/or abstinence, they can occasionally become chronic and persistent.[4] Alcoholic psychosis is sometimes misdiagnosed as another mental illness such as schizophrenia.[7]
  • F12.5 cannabinoid: Some studies indicate that cannabis, especially certain strains containing large proportions of THC and low proportions of CBD,[8] may lower the threshold for psychosis, and thus help to trigger full-blown psychosis in some people.[9] 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.[10] 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.[11]
  • 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.[24][25]


  • 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.).[51] Various "JWH-XXX" compounds in "Spice" or "Incense" [52] have also been found.
    • Mephedrone and related amphetamine-like drugs sold as "bath salts" or "plant food".[53]

See alsoEdit


  1. Larson, Michael Alcohol-Related Psychosis. eMedicine. WebMD. URL accessed on September 27, 2006.
  2. Soyka, Michael (March 1990). Psychopathological characteristics in alcohol hallucinosis and paranoid schizophrenia. Acta Psychiatrica Scandinavica 81 (3): 255–9.
  3. Gossman, William Delirium Tremens. eMedicine. WebMD. URL accessed on October 16, 2006.
  4. 4.0 4.1 Alcohol-Related Psychosis
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  10. 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.
  11. Degenhardt L, Hall W, Lynskey M (2001). Comorbidity between cannabis use and psychosis: Modelling some possible relationships..
  12. 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.
  13. 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.
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  18. Lader M, Morton S. Benzodiazepine Problems. British Journal of Addiction 1991; 86: 823-828
  19. Benzodiazepines: Paradoxical Reactions & Long-Term Side-Effects
  20. Hansson O, Tonnby B. [Serious Psychological Symptoms Caused by Clonazepam.] Läkartidningen 1976; 73: 1210-1211.
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  43. PMID 438794 (PMID 438794)
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