Mental Health Monday–Drug-Induced Psychosis

Writer Colleen Rowan Kosinski asked about Substance-Induced Psychosis.

Here are the basics:

Drugs (legal and illegal) and even some herbal supplements when taken in excess can cause psychosis. Common offenders include alcohol, marijuana, cocaine, heroin, amphetamines (meth), and hallucinogens such as LSD and PCP. Prescribed medications such as prednisone, isoretinoin, scopolamine, L-dopa (used for Parkinson Disease), and anti-epileptics can also cause psychosis.

Substance-Induced Psychosis is something we see frequently in the inpatient psych unit and psychiatric ER (crisis unit). Obtaining a thorough history (from the patient and collateral sources) as well as getting a urine drug screen can identify which substances the person ingested. Some aren’t so easy to detect however.

New to the scene are synthetic marijuana (K2) and “spice” or “incense” (with mephedrone as the active ingredient). The psychosis caused by these substances tends to be more…intense. People can become severely psychotic, with paranoia, hallucintations, disorganized and fragmented thoughts, confusion, disorientation, and a tendency toward violence. Their symptoms are also less likely to respond to medications such as anti-psychotics. They end up spending a long time on the unit and don’t necessarily recover completely.

So what’s the best treatment for someone suffering from substance-induced psychosis?

• Keep them safe (usually in the ER or on the psych unit)
• Try to reduce stimuli as much as possible (dark, quiet rooms)
• Provide structure (the same routine every day helps orient them)
• Give anti-psychotic medication such as Haldol, Risperdal, Zyprexa, etc.
• Use adjunctive medications to help with anxiety and withdrawal symptoms, if present; Clonidine, Motrin, Immodium, Benadryl, Ativan, etc.

Like Mr. Mackey from South Park says:

Drugs are bad, M’kay?

Just don’t do it! 😉

DO check out Lydia’s Medical Monday post and Sarah’s The Strangest Situation!

Remember these posts are for writing purposes only and are NOT to be construed as medical advice of treatment.