Understanding Drug-Induced Schizophrenia : Symptoms, Causes, and Treatment

Many people use recreational drugs like cannabis, cocaine, heroin, or hallucinogens for fun and to get a high. However, these drugs can easily change a person’s perception of reality. This alteration of reality is known as drug-induced psychosis during which a person is left incapable of distinguishing between what’s real and what does not exist. If, however, you are using these drugs deliberately and looking to experience this type of psychosis, you may eventually develop a chronic condition. This short-term break from reality that drug users seek may often lead to the psychosis persisting even after the drug has worn off. This is known as drug-induced schizophrenia. This is a chronic psychotic disorder that causes symptoms like delusions and hallucinations. Here’s everything you need to know about drug-induced schizophrenia.

Drug-induced schizophrenia is a condition in which a person experiences a certain type of psychosis due to the effects of drugs on the brain. It is interesting to note that drug-induced schizophrenia is very similar to drug-induced psychosis and many people often use the two terms interchangeably, though there are certain differences in the symptoms of the two conditions. Psychosis is a term used to refer to a disconnection from reality or a change in your perception of reality that causes you to experience hallucinations or delusions.^(1,2) Delusions are when people start to believe things that are not true, while hallucinations are when a person experiences things that are not there. People with psychosis also behave in strange and unusual ways, such as believing that the government is tracking them or becoming overly suspicious or obsessive over things like home security.^(3,4)

When a person uses any type of substance like prescription medications or recreational drugs, they may have a certain type of reaction or response to it. In some cases, this response is what they are seeking and so they deliberately start taking that substance in order to achieve results that give a temporary break from reality. On the other hand, it is also possible that the psychosis that occurs after drug use is unintentional. This usually happens in cases where a person is trying out a new medication, using certain substances or drugs for the first time, or combining two medications for the first time.^(5,6)

Many people tend to recover from this type of short-term psychosis without needing any type of treatment. The symptoms of psychosis disappear once the effects of the drugs wear off. Others, however, tend to go on to develop drug-induced schizophrenia, which is a chronic condition. The symptoms of drug-induced schizophrenia are often worse and more chronic when compared to the symptoms of drug-induced psychosis.^(7,8)

The main difference between drug-induced psychosis and drug-induced schizophrenia is that while drug-induced psychosis is a short-term lapse in the brain’s ability to make out what is real and what is not, drug-induced schizophrenia is a chronic mental health condition that happens after taking a certain substance. However, drug-induced schizophrenia is not usually directly caused by substance use. Instead, it is usually because of a result of many complex factors, including other mental health concerns and hereditary risks. In drug-induced psychosis, people usually deliberately seek out the psychosis with the use of certain substances and the psychosis usually ends after the substance is eliminated from the body and no longer affects the central nervous system.^(9,10)

Drug-induced schizophrenia causes many symptoms, including:⁽¹¹⁾

• Delusions
• Hallucinations
• Disorganized speech
• Loss of function, especially when it comes to doing daily chores
• Catatonic or erratic behavior
• Reduced ability to experience any type of positive emotions or joy

In order to be diagnosed with drug-induced schizophrenia, you need to experience at least two of these symptoms on a regular basis. Out of these symptoms, one must be that of hallucinations, delusions, or disorganized speech.

Since drug-induced schizophrenia is a long-term condition, these symptoms are usually ongoing and they may change in their intensity and severity. Some symptoms may be more severe at certain times while others might increase and reduce in intensity. The symptoms and experiences of drug-induced schizophrenia differ for every person.⁽¹²⁾

Using certain drugs and/or medications without any other factor is not enough to cause drug-induced schizophrenia. At the same time, not everybody who uses such substances go on to develop drug-induced schizophrenia.⁽¹³⁾

Studies have shown that people who do develop drug-induced schizophrenia did use some substance at some point in time, but they also had other pre-existing conditions or issues that also played a major role and contributed to the development of drug-induced schizophrenia. So it is important to realize that substance use alone is not going to cause drug-induced schizophrenia, though using drugs might kick start the condition.⁽¹⁴⁾

One study discovered that around one in four people who experienced drug-induced psychosis in the initial stages eventually went on to develop drug-induced schizophrenia.⁽¹⁵⁾ Another study from 2017 also showed similar results and found that 17 percent of people who were admitted to a Scottish hospital for the treatment of drug-induced psychosis eventually also went on to develop drug-induced schizophrenia. In fact, most patients were diagnosed with drug-induced schizophrenia within five years of being admitted to the hospital for drug-induced psychosis.⁽¹⁶⁾

While research shows this association, it is equally necessary to know that researchers do not clearly understand exactly what drugs cause this and how the initial symptoms develop.

While any type of substance or drug can cause drug-induced schizophrenia, some substances or drugs are much more likely to cause the condition than others. It also does not need to be a specific recreational drug or prescription medication. Any substance, especially if it is not being used as it is intended, could cause the symptoms of drug-induced schizophrenia.

A study carried out in 2020 discovered that there are three main types of common drugs that were the strongest predictors of whether a person is going to go from experiencing drug-induced psychosis to drug-induced schizophrenia.⁽¹⁷⁾ In order of their strength, these commonly used drugs are:

• Cannabis
• Hallucinogens
• Amphetamines

On the other hand, there are lower rates of transitioning to drug-induced schizophrenia from drug-induced psychosis when people use alcohol, sedatives, and opioids. Other substances that are linked to drug-induced psychosis can also eventually cause drug-induced schizophrenia. Some studies have shown that the risk gets higher when larger doses are taken or due to prolonged use.⁽¹⁸⁾ These include:

• Alcohol
• Sedatives
• Hypnotics
• Inhalants
• Stimulants like cocaine
• Anti-anxiety medication or anxiolytics

There are many other medications that may also play a role in the development of drug-induced schizophrenia, including:

• Corticosteroids
• Antidepressants
• Antihistamines
• Cardiovascular medications
• Chemotherapy drugs
• Gastrointestinal drugs
• Antihypertensives
• Anticonvulsants
• Over-the-counter painkillers, including nonsteroidal anti-inflammatory drugs (NSAIDs) and analgesics

There is another possibility that some other substances could also be linked to drug-induced schizophrenia.⁽¹⁹⁾

Again, as mentioned earlier, this becomes more likely if these substances are not taken as they are intended. The first sign that you are experiencing a symptom is the development of psychosis or a change in your perception of reality. This is why it is important to take note that psychosis can eventually go on to develop into becoming a chronic concern at a later stage.⁽²⁰⁾

There is no diagnostic test that can confirm and conclusively diagnose drug-induced schizophrenia, though your doctor will prescribe drug tests to confirm whether or not you are under the influence of any drugs. More than this, though, doctors tend to diagnose the condition by looking at your symptoms. Then, to further confirm this diagnosis, they make you stop using the drugs. If the symptoms disappear, it is concluded that the psychosis symptoms were drug-induced, and if they do not, you are believed to have schizophrenia or any other mental health disorder.⁽²¹⁾

Drug-induced schizophrenia is a chronic condition that lasts lifelong. It also needs to be monitored closely by a mental health professional to ensure the proper management of your symptoms. Treatment for drug-induced schizophrenia includes:⁽²²⁾

• Providing psychosocial support: This includes vocational training to help a patient maintain a job, do their daily tasks, and function in a social setting.
• Needing family support: Your family and friends will play an important role in the management of your schizophrenia symptoms. They will be taught various ways to help manage the condition and how to support you. Your mental health doctor may also recommend that your caregivers, family, and friends attend training sessions or classes to understand more about this condition and how to deal with the symptoms.
• Training in social skills: People with drug-induced schizophrenia often find it difficult to interact with others in social settings due to the impact of their hallucinations and/or delusions. Training in social skills helps you interact with others and feel more confident in your skills and responses.

Apart from these, you might also need to undergo a rehabilitation program in order to stop using whatever substance or medication you were using that caused this condition to develop. Keep in mind that if you keep taking these substances, it may interfere with your schizophrenia treatment.⁽²³⁾

Drug-induced schizophrenia is a condition that is caused by substance use, but it is not directly linked with substance use. Instead, the condition develops due to a variety of factors, including substance use, family history of drug use or mental health conditions, and other underlying issues. It is important that you are aware that drug-induced schizophrenia is a chronic and lifelong condition. The symptoms of the condition will continue to persist for the rest of your life, varying in severity and intensity every now and then. It is possible to manage this condition and your symptoms with help from a mental health professional, who will find the best possible treatment for your individual needs.

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