The Causes of Drug-Induced Psychosis
Psychosis, as a general condition, is caused by abnormally high dopamine levels. Drug-induced psychosis usually occurs when a person abuses a stimulant, such as methamphetamine. However, many other drugs, aside from stimulants, can also cause psychosis.
Among these are marijuana, salvia divinorum, hallucinogens including LSD, and even some prescription medications such as antidepressants.
Drug-induced psychosis, or toxic psychosis, is characterized by a break from reality as a result of ingesting a drug. There are many factors, however, that may influence whether a person is susceptible to experiencing psychosis from using a drug, as well as how severe that psychosis will prove to be.
Factors Which Influence Drug-Induced Psychosis
The Drug(s) Itself
The drug itself (or combination of drugs) is probably the biggest influence on a psychotic break.
As noted, stimulant-based drugs are more apt to cause psychosis, but these are more apt to be illicit drugs such as methamphetamine than say, prescription amphetamines taken at proper doses.
Also, psychosis resulting from ingestion of certain drugs such as antidepressants or corticosteroids is possible, but far less likely than a street stimulant. And a combination of drugs can have an unexpected effect that may not have occurred otherwise, if just one of the drugs had been ingested.
Naturally, the more of a drug that is ingested, the more likely psychosis will occur. If by prescription, taking the recommended amount is unlikely to result in psychosis (but not impossible.)
Those who take a high doses of a particular drug tend to experience a change in their neurochemistry. The more potent the doses, the more likely it is that neurotransmitters, brain waves, and regional activation will be altered.
Conversely, lower doses are associated with less neurochemical changes. Yes, you can experience psychosis on a relatively low dose of a drug, but the likelihood is minimized.
Short-term vs. Long-term Usage
Short-term users of a drug are less likely to experience drug-induced psychosis than long-term users. This is because long-term users have an increased tolerance and are more likely to be taking higher doses.
Also, long-term use of certain drugs can modify a person’s physiology. These changes can accumulate over time, and lead to an altered functioning of the central nervous system.
Those that use a drug short-term are less likely to experience drug-induced psychosis than those who use over a long-term. This is because that long-term users have often built up a tolerance to the drug, and are therefore taking higher doses.
Not surprisingly, those who have a pre-existing mental condition are much more likely to experience a drug-induced psychosis. This is because they may have abnormal levels of certain neurotransmitters, which may lead to a stronger reaction in the brain to psychoactive substances.
This is very true for those with schizophrenia, who are especially prone to psychotic breaks during drug use – in fact, even marijuana has found to effect sufferers in a negative way. Persons with other mental illnesses, however, such as major depressive disorder or bipolar disorder, may also be more susceptible to drug-induced psychosis.
Younger persons are more likely to experience drug-induced psychosis due to the immaturity of certain brain regions. The brain may not be fully developed until age 25, and until then, regions are still forming.
Use or abuse of some drugs during this time can interfere with neural development, and thus increase vulnerability to psychosis.
There may be some genetic factors which predispose a person to drug-induced psychosis. For example, those with first-degree relatives who have a serious mental illness (i.e. schizophrenia) are thought to be at a heightened risk for drug-induced psychosis. Moreover, there are specific genes that control both arousal and neurotransmitter levels, and variations in these could make one more prone to drug-based psychosis.
Previous Psychotic Episode
If you have had a psychotic episode previously, whether brought on by mental illness or a drug, your brain may be predisposed to experience another. This is especially true if you are using a drug that has already caused a psychotic break – in fact, you may be setting yourself up to experience one that is even more severe.
Continuous psychotic episodes brought on by drug use can lead to permanent brain damage and possibly lifelong issues with psychosis. Moreover, having a psychotic break for any reason may increase the likelihood of having another, and each episode makes your brain more and more susceptible to psychosis in the future.
As noted, taking drug in combinations may have unpredictable interactions. Taking multiple substances that increase dopamine, for example, can increase dopamine levels to an unhealthy extent. Even over-the-counter medicines, caffeine, and alcohol can interact with certain drugs to induce psychosis.
Sleep deprivation and/or Stress Levels
Severe sleep deprivation in of itself can lead to psychotic symptoms. Therefore, if a person is sleep deprived, taking certain substances can be enough to bring on a psychotic break.
This may create a synergistic effect if the drug being used is actually the one responsible for the sleep deprivation (for example, this is a common side effect of both methamphetamine and cocaine.)
High stress levels can also contribute to a drug-induced psychotic break. This is because high stress can invoke a number of neurochemical, hormonal, and physiological changes, all of which may increase your vulnerability to psychosis. Regular use of some drugs can increase stress levels, thus also increasing the risk of a psychotic disturbance.
Here is a list of substances that can induce psychosis, although the likelihood of it occurring may vary greatly from substance to the next.
List of Drugs That Can Induce Psychosis
- Cannabis (Marijuana)
- Inhalants such as butane, gasoline, and toluene
- MDMA (Ecstasy)
- Mephedrone (“Bath Salts”)
- LSD (Lysergic acid diethylamide)
- PCP (Phencyclidine)
- Synthetic Cannabinoids
- Belladonna (Nightshade)
- Jimson Weed (Datura Stramonium)
- Morning Glory Seeds (Ipomoea Tricolor)
- Salvia Divinorum
Prescription or Over-The-Counter Medications
- Decarboxylase Inhibitors
- Isotretinoin (Accutane)
- OTC antihistimines such as diphenhydramine, pheniramine, and promethazine
- OTC cold medicines containing dextromethorphan (DXM) or phenylpropanolamine (PPA)
~ G. Nathalee Serrels, M.A., Psychology
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