Table of ContentsView AllTable of ContentsCausesSymptomsDiagnosisTreatmentOutlook
Table of ContentsView All
View All
Table of Contents
Causes
Symptoms
Diagnosis
Treatment
Outlook
Drug-inducedschizophreniacan affect people who take certain drugs or substances that lead to symptoms of this serious mental health condition, including cannabis or amphetamine use. Research finds that more than 25% of people who have a substance-induced psychotic episode will later be diagnosed with schizophrenia.
This condition typically begins as substance-inducedpsychosis, which is a break from reality following taking or withdrawing from a substance. The affected person experiences delusions, hallucinations, and other cognitive and emotional symptoms.
This article will discuss the relationship between drug-induced psychosis and schizophrenia and how it’s treated.
Ingesting or withdrawing from certain medications, drugs, and alcohol can cause episodes ofpsychosis. Not everyone who has an episode of drug-induced psychosis will later be diagnosed with schizophrenia, though. It is important to differentiate between the two conditions.
Schizophrenia is a persistent and complex condition with many factors contributing to its causes.Research does indicate that the type of drug a person takes before an episode of substance-induced psychosis can be a predictor of whether they will later develop schizophrenia.
One review found that the highest rates of substance-induced psychosis that later transitions into schizophrenia occur in people using:
Opioids, alcohol, and sedatives have slightly lower rates of producing this transition, but they are still associated.
Substance Abuse and Schizophrenia CrossoverKeep in mind that there is some crossover between people who are predisposed to substance use disorders and those who are predisposed to psychiatric conditions like schizophrenia.Both genetic and environmental factors, like childhood trauma, are linked to both conditions.
Substance Abuse and Schizophrenia Crossover
Keep in mind that there is some crossover between people who are predisposed to substance use disorders and those who are predisposed to psychiatric conditions like schizophrenia.Both genetic and environmental factors, like childhood trauma, are linked to both conditions.
Cannabis
The use of cannabis and schizophrenia are linked, but it has been challenging for researchers to tease out the precise relationship.
A recent review found some evidence that cannabis can have a small effect on causing schizophrenia as well as exacerbating symptoms of existing schizophrenia.However, there was also evidence that the cannabidiol (CBD) component of cannabis may have some therapeutic benefit for existing schizophrenia.
As cannabis becomes legal in more states, more research will likely be done.
Risk Factors
Substance-induced psychosis is a significant risk factor for later developing schizophrenia. A 2017 study tracked the number of people who were first admitted with substance-induced psychosis and later transitioned to schizophrenia over a 15.5-year period.
In the study, the risk factors for developing schizophrenia also included:
There is also a largegenetic factorwith schizophrenia. A person may be at greater risk of developing schizophrenia if they have close relatives with the condition. Some research suggests that the same genetic factors play a role in both developing schizophrenia and the risk of drug-induced psychosis that progresses to schizophrenia when compared with people who don’t progress to a diagnosis.
Seek HelpIf you or a loved one are struggling with psychosis and are at risk of self-harm or hurting others, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.
Seek Help
If you or a loved one are struggling with psychosis and are at risk of self-harm or hurting others, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.
If you or a loved one are struggling with psychosis and are at risk of self-harm or hurting others, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat800-662-4357for information on support and treatment facilities in your area.
For more mental health resources, see ourNational Helpline Database.
The primary symptoms of schizophrenia include:
There can be many other symptoms present, including aflat affect(lack of expression) andcatatonic behavior(unusual movements or speech) and each person will present differently.
Delusions
Adelusionis a fixed, false belief that is not based in reality.Examples of delusions common in schizophrenia are believing that others are out to hurt you, believing that others can hear your thoughts or are putting thoughts into your head, and believing that you have extra powers or magic.
Hallucinations
Ahallucinationis a sensory experience that does not exist in reality. They can be auditory (sound), visual (sight), tactile (touch), olfactory (smell), or gustatory (taste). Common hallucinations include seeing people who aren’t there and hearing voices.
Disorganized Speech
Disorganized speech and behavior are common in people diagnosed with schizophrenia. They may jump from one topic to the next with seemingly no connection or coherence. They also may behave oddly, speaking as if they were children or becoming easily agitated.
A person with schizophrenia typically has little to no insight into their delusions or hallucinations. They will believe that what they are experiencing is real and it may be difficult to convince them otherwise.
Length of Episodes Last
Acute episodes of psychosis can last hours, days, weeks, or months, and in many cases may require hospitalization to ensure the person’s safety.
Stopping drug use does not necessarily mean that symptoms will immediately cease, but it is the first step. Studies show that both the type of substance and the level of use contribute to whether or not a person will develop drug-induced schizophrenia and how it will progress.
Mental health professionals use the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5) to diagnose psychiatric conditions such as schizophrenia. To be diagnosed with schizophrenia, a person must experience at least one of the symptoms of hallucinations, delusions, or disorganized speech.
Additionally, they must exhibit one or more other symptoms that can also include catatonic behavior or a flat affect. These symptoms must persist most of the time for at least one month, at levels that interfere with work, relationships, and other features of daily life.
Physiological testing cannot diagnose schizophrenia, but it may be used to rule out other conditions. These tests can include:
In diagnosis, it is important to differentiate substance-induced psychotic disorder from schizophrenia. Only some people will transition to schizophrenia.
Treating schizophrenia can help limit the number of acute psychotic episodes a person experiences and increase their engagement and functioning in daily life. However, some people with schizophrenia are reluctant to get treatment or they have no insight into their delusions or hallucinations.
Hospitalization
Hospitalization can be an essential part of a person’s treatment and recovery from a drug-induced episode of psychosis or an exacerbation (worsening) of schizophrenia. Studies show that up to one in four people hospitalized with psychosis for the first time have substance-induced symptoms.
Close-contact medical treatment in a hospital setting can help the person manage the psychosis symptoms and their withdrawal from substances. It also can form a comprehensive discharge plan for ongoing treatment, psychotherapy, community support, housing, and rehabilitation.
Medication and Psychotherapy
Antipsychotics are used in the treatment of schizophrenia.These include both “typical” antipsychotics, like chlorpromazine and Haldol (haloperidol), and “atypical” antipsychotics, like Risperdal or Risvan (risperidone), and Clozaril (clozapine).
For people experiencing psychosis as a result of substance use, additional medication may be used to help a person withdraw from those substances.
Psychotherapy (talk therapy) can also be an important part of the patient’s treatment plan.
Paranoid Personality Disorder Treatment
Schizophrenia is a chronic, lifelong psychiatric condition. There is no cure for schizophrenia, although there are effective treatments available that can help manage symptoms and avoid triggers.
Summary
Episodes of drug-induced schizophrenia occur when the use of cannabis, amphetamines, and other substances leads to hallucinations and other symptoms of psychosis. Substance use disorder, drug-induced psychosis, and schizophrenia can all be closely associated.
It may be that substances exacerbate symptoms of schizophrenia, that people use substances to cope with schizophrenia symptoms, or that environmental and genetic factors predispose a person to both conditions. Research is ongoing, but all three conditions are complex, and each person’s case is unique.
Treatment options typically span a lifetime and can include medication, hospitalization, and therapy. Talk to your healthcare provider if you have concerns about drug-induced schizophrenia.
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Murrie B, Lappin J, Large M, Sara G.Transition of substance-induced, brief, and atypical psychoses to schizophrenia: a systematic review and meta-analysis.Schizophrenia Bulletin. 2020;46(3):505-516. doi:10.1093/schbul/sbz102Ham S, Kim TK, Chung S, Im H-I.Drug abuse and psychosis: new insights into drug-induced psychosis.Exp Neurobiol. 2017;26(1):11-24. doi:10.5607/en.2017.26.1.11Kendler KS, Ohlsson H, Sundquist J, Sundquist K.Prediction of onset of substance-induced psychotic disorder and its progression to schizophrenia in a swedish national sample.AJP. 2019;176(9):711-719. doi:10.1176/appi.ajp.2019.18101217Patel S, Khan S, M S, Hamid P.The association between cannabis use and schizophrenia: causative or curative? A systematic review.Cureus. 2020;12(7). doi:10.7759/cureus.9309Alderson HL, Semple DM, Blayney C, Queirazza F, Chekuri V, Lawrie SM.Risk of transition to schizophrenia following first admission with substance-induced psychotic disorder: a population-based longitudinal cohort study.Psychological Medicine. 2017;47(14):2548-2555. doi:10.1017/S0033291717001118Tandon R, Shariff SM.Substance-induced psychotic disorders and schizophrenia: pathophysiological insights and clinical implications.AJP. 2019;176(9):683-684. doi:10.1176/appi.ajp.2019.19070734MedlinePlus.Hallucinations.Picardi A, Fonzi L, Pallagrosi M, Gigantesco A, Biondi M.Delusional Themes Across Affective and Non-Affective Psychoses.Front Psychiatry. 2018 Apr 5;9:132. doi:10.3389/fpsyt.2018.00132American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders.5th ed. Washington D.C.: 2013.Edinoff A, Wu N, deBoisblanc C, Feltner CO, Norder M, Tzoneva V,et al.Lumateperone for the Treatment of Schizophrenia.Psychopharmacol Bull. 2020 Sep 14;50(4):32-59. PMID: 33012872;Azorin J-M, Simon N.Antipsychotic polypharmacy in schizophrenia: evolving evidence and rationale.Expert Opinion on Drug Metabolism & Toxicology. 2020;16(12):1175-1186. doi:10.1080/17425255.2020.1821646
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Murrie B, Lappin J, Large M, Sara G.Transition of substance-induced, brief, and atypical psychoses to schizophrenia: a systematic review and meta-analysis.Schizophrenia Bulletin. 2020;46(3):505-516. doi:10.1093/schbul/sbz102Ham S, Kim TK, Chung S, Im H-I.Drug abuse and psychosis: new insights into drug-induced psychosis.Exp Neurobiol. 2017;26(1):11-24. doi:10.5607/en.2017.26.1.11Kendler KS, Ohlsson H, Sundquist J, Sundquist K.Prediction of onset of substance-induced psychotic disorder and its progression to schizophrenia in a swedish national sample.AJP. 2019;176(9):711-719. doi:10.1176/appi.ajp.2019.18101217Patel S, Khan S, M S, Hamid P.The association between cannabis use and schizophrenia: causative or curative? A systematic review.Cureus. 2020;12(7). doi:10.7759/cureus.9309Alderson HL, Semple DM, Blayney C, Queirazza F, Chekuri V, Lawrie SM.Risk of transition to schizophrenia following first admission with substance-induced psychotic disorder: a population-based longitudinal cohort study.Psychological Medicine. 2017;47(14):2548-2555. doi:10.1017/S0033291717001118Tandon R, Shariff SM.Substance-induced psychotic disorders and schizophrenia: pathophysiological insights and clinical implications.AJP. 2019;176(9):683-684. doi:10.1176/appi.ajp.2019.19070734MedlinePlus.Hallucinations.Picardi A, Fonzi L, Pallagrosi M, Gigantesco A, Biondi M.Delusional Themes Across Affective and Non-Affective Psychoses.Front Psychiatry. 2018 Apr 5;9:132. doi:10.3389/fpsyt.2018.00132American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders.5th ed. Washington D.C.: 2013.Edinoff A, Wu N, deBoisblanc C, Feltner CO, Norder M, Tzoneva V,et al.Lumateperone for the Treatment of Schizophrenia.Psychopharmacol Bull. 2020 Sep 14;50(4):32-59. PMID: 33012872;Azorin J-M, Simon N.Antipsychotic polypharmacy in schizophrenia: evolving evidence and rationale.Expert Opinion on Drug Metabolism & Toxicology. 2020;16(12):1175-1186. doi:10.1080/17425255.2020.1821646
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Murrie B, Lappin J, Large M, Sara G.Transition of substance-induced, brief, and atypical psychoses to schizophrenia: a systematic review and meta-analysis.Schizophrenia Bulletin. 2020;46(3):505-516. doi:10.1093/schbul/sbz102Ham S, Kim TK, Chung S, Im H-I.Drug abuse and psychosis: new insights into drug-induced psychosis.Exp Neurobiol. 2017;26(1):11-24. doi:10.5607/en.2017.26.1.11Kendler KS, Ohlsson H, Sundquist J, Sundquist K.Prediction of onset of substance-induced psychotic disorder and its progression to schizophrenia in a swedish national sample.AJP. 2019;176(9):711-719. doi:10.1176/appi.ajp.2019.18101217Patel S, Khan S, M S, Hamid P.The association between cannabis use and schizophrenia: causative or curative? A systematic review.Cureus. 2020;12(7). doi:10.7759/cureus.9309Alderson HL, Semple DM, Blayney C, Queirazza F, Chekuri V, Lawrie SM.Risk of transition to schizophrenia following first admission with substance-induced psychotic disorder: a population-based longitudinal cohort study.Psychological Medicine. 2017;47(14):2548-2555. doi:10.1017/S0033291717001118Tandon R, Shariff SM.Substance-induced psychotic disorders and schizophrenia: pathophysiological insights and clinical implications.AJP. 2019;176(9):683-684. doi:10.1176/appi.ajp.2019.19070734MedlinePlus.Hallucinations.Picardi A, Fonzi L, Pallagrosi M, Gigantesco A, Biondi M.Delusional Themes Across Affective and Non-Affective Psychoses.Front Psychiatry. 2018 Apr 5;9:132. doi:10.3389/fpsyt.2018.00132American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders.5th ed. Washington D.C.: 2013.Edinoff A, Wu N, deBoisblanc C, Feltner CO, Norder M, Tzoneva V,et al.Lumateperone for the Treatment of Schizophrenia.Psychopharmacol Bull. 2020 Sep 14;50(4):32-59. PMID: 33012872;Azorin J-M, Simon N.Antipsychotic polypharmacy in schizophrenia: evolving evidence and rationale.Expert Opinion on Drug Metabolism & Toxicology. 2020;16(12):1175-1186. doi:10.1080/17425255.2020.1821646
Murrie B, Lappin J, Large M, Sara G.Transition of substance-induced, brief, and atypical psychoses to schizophrenia: a systematic review and meta-analysis.Schizophrenia Bulletin. 2020;46(3):505-516. doi:10.1093/schbul/sbz102
Ham S, Kim TK, Chung S, Im H-I.Drug abuse and psychosis: new insights into drug-induced psychosis.Exp Neurobiol. 2017;26(1):11-24. doi:10.5607/en.2017.26.1.11
Kendler KS, Ohlsson H, Sundquist J, Sundquist K.Prediction of onset of substance-induced psychotic disorder and its progression to schizophrenia in a swedish national sample.AJP. 2019;176(9):711-719. doi:10.1176/appi.ajp.2019.18101217
Patel S, Khan S, M S, Hamid P.The association between cannabis use and schizophrenia: causative or curative? A systematic review.Cureus. 2020;12(7). doi:10.7759/cureus.9309
Alderson HL, Semple DM, Blayney C, Queirazza F, Chekuri V, Lawrie SM.Risk of transition to schizophrenia following first admission with substance-induced psychotic disorder: a population-based longitudinal cohort study.Psychological Medicine. 2017;47(14):2548-2555. doi:10.1017/S0033291717001118
Tandon R, Shariff SM.Substance-induced psychotic disorders and schizophrenia: pathophysiological insights and clinical implications.AJP. 2019;176(9):683-684. doi:10.1176/appi.ajp.2019.19070734
MedlinePlus.Hallucinations.
Picardi A, Fonzi L, Pallagrosi M, Gigantesco A, Biondi M.Delusional Themes Across Affective and Non-Affective Psychoses.Front Psychiatry. 2018 Apr 5;9:132. doi:10.3389/fpsyt.2018.00132
American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders.5th ed. Washington D.C.: 2013.
Edinoff A, Wu N, deBoisblanc C, Feltner CO, Norder M, Tzoneva V,et al.Lumateperone for the Treatment of Schizophrenia.Psychopharmacol Bull. 2020 Sep 14;50(4):32-59. PMID: 33012872;
Azorin J-M, Simon N.Antipsychotic polypharmacy in schizophrenia: evolving evidence and rationale.Expert Opinion on Drug Metabolism & Toxicology. 2020;16(12):1175-1186. doi:10.1080/17425255.2020.1821646
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