Drug-induced psychosis and schizophrenia: How do they differ? 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However, schizophrenia can have several different causes, whereas drug-induced psychosis only occurs from drug use. It also has fewer symptoms than schizophrenia. This article summarizes the main differences between drug-induced psychosis and schizophrenia and discusses their causes, symptoms, and diagnosis. It will also detail the treatment and outlook for both conditions. Key differences Share on PinterestChelsea Victoria/StocksyAccording to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR), there are several key differences between schizophrenia and drug-induced psychosis. The table below outlines them.SchizophreniaDrug-induced psychosisWhat are the symptoms?Schizophrenia must include delusions, hallucinations, or disorganized speech. They may also include disorganized behavior and catatonic behavior.Drug-induced psychosis must include delusions or hallucinations.What are the causes?Genetic and environmental factors. Drug-induced psychosis can also transition into schizophrenia.Taking drugs, such as cannabis, hallucinogens, and amphetamines.How long can it last?Symptoms must affect a person for at least 6 months before they can receive a diagnosis. People can experience recovery periods that last for years, but typically it is a chronic condition.The acute phase may only last a few hours. However, symptoms can persist for several weeks.How do doctors treat it?Antipsychotic medications can help with the acute phase. They can also be useful in the longer term, alongside nonpharmaceutical interventions, such as cognitive behavioral therapy (CBT).Antipsychotic medications help manage the acute phase. Doctors may then try to address the underlying cause of the drug use. Causes Research from 2021 states that drug-induced psychosis refers to a psychotic episode from the misuse of or withdrawal from a drug. The authors write that it may also have links to:higher levels of dopaminethe severity of drug misuse and dependencemisusing more than one drug The DSM-5-TR defines substance-induced psychotic disorder as a psychiatric disease that features delusions, hallucinations, or both during or soon after substance intoxication or withdrawal. Furthermore, health experts are yet to fully understand the symptoms of a psychotic disorder that do not relate to substance use. Authors of a 2020 systematic review and meta-analysis write that drug-induced psychosis can lead to long-term experiences of psychotic conditions such as schizophrenia. They note that research suggests a person is at significant risk of transitioning from drug-induced psychosis to long-term illness if they take cannabis, hallucinogens, or amphetamines. However, this transition may be less frequent in opioids, alcohol, and sedative use. Not all drug use leads to drug-induced psychosis. Scientists remain unsure about why some drug use leads to these episodes. However, research has shown that several different drugs are able to cause them. These include:cannabishallucinogensamphetaminesalcohol withdrawalsedatives withdrawal Causes of psychosis The National Institute of Mental Health (NIMH) writes that there is no one cause for psychosis. It may be a symptom of a mental health condition such as schizophrenia. Other causes include:sleep deprivationsome prescription medicationsalcohol misusecannabis Causes of schizophrenia Overall, scientists are uncertain about the exact causes of schizophrenia. However, possible causes include having multiple issues within the brain’s neurotransmitters, which may sometimes have a genetic basis. Scientists have also identified environmental risk factors for schizophrenia. These include:atypical fetal developmentgestational diabeteslow birth weighthaving a complicated birth, such as the mother having an infection during pregnancymaternal malnutritionbeing born in the winterliving in an urban environment Symptoms The DSM-5-TR lists the symptoms of drug-induced psychosis and schizophrenia. Symptoms of drug-induced psychosis include delusions and hallucinations. The following are symptoms of drug-induced schizophrenia:delusionshallucinationsdisorganized speech, which may be unfocused or incoherenthighly disorganized or catatonic behaviordiminished emotional expression or lack of motivation Diagnosis The DSM-5-TR states that doctors and psychiatrists must consider several different factors to diagnose drug-induced psychosis and schizophrenia. To diagnose an individual with drug-induced psychosis, medical professionals must be confident of the following criteria:the individual has at least one symptom of drug-induced psychosisthe symptoms must have begun during or just after drug use or during drug withdrawalthe symptoms are not the result of a different psychotic disorderthe symptoms persist even when the individual is not intoxicated the symptoms cause significant problems with the individual’s work or social functioning To diagnose an individual with schizophrenia, medical professionals must be confident of the following criteria:for at least 1 month, the individual has at least two schizophrenia symptomsfor at least 1 month, one of those symptoms must be delusions, hallucinations, or disorganized speechthe symptoms cause significant problems with the individual’s work, social functioning, or ability to self-carethe symptoms do not indicate conditions such as schizoaffective disorder, depression, or bipolar disorderthe symptoms are not the direct result of drug usethe individual has some negative symptoms, such as a diminished emotional expression or lack of motivation In autistic people or those with childhood communication disorders, schizophrenia diagnoses are more complicated. Healthcare professionals must make sure that the individual has experienced severe delusions or hallucinations for at least 1 month. Treatment and management According to a 2022 review, doctors mainly treat drug-induced psychosis with antipsychotic medications. These medications help manage the symptoms during the acute phase of this condition. After the acute phase has passed, doctors will attempt to address the underlying cause. With drug-induced psychosis, drug intoxication might have played a role. However, treatment for schizophrenia is very complex. Research has shown that certain oral antipsychotic medications can help with the acute phase of the condition. After an acute phase of schizophrenia, doctors typically recommend antipsychotics in the form of a slow-acting injection. This can help the individual avoid symptom relapse and maintain their treatment. Nonpharmacological interventions are also useful and might include art therapy, drama therapy, or CBT. A person should also get support while they gradually reenter their community. Outlook The outlook for people with schizophrenia varies greatly. Certain factors can make it harder for individuals to manage their condition. These include:a slow, gradual disease onsetthe disease beginning during childhood or adolescencean impaired ability to think However, other factors can make it easier for people to manage their condition:acute disease onsetbeing femaleliving in a developed country Schizophrenia can severely disrupt someone’s personal and professional life. It can also lead to suicidal ideation. In people with this condition, the most common cause of premature death is suicide. According to 2019 research, between 24% and 32% of people with drug-induced psychosis may go on to develop other mental health conditions, such as bipolar disorder or schizophrenia spectrum disorder. This risk is highest in people whose drug-induced psychosis came from cannabis use. Overall, the outlook for people with drug-induced psychosis is uncertain. A 2021 study notes there is very little data on the treatment, outcome, and clinical best practices regarding drug-induced psychosis. Suicide prevention If you know someone at immediate risk of self-harm, suicide, or hurting another person:Ask the tough question: “Are you considering suicide?”Listen to the person without judgment.Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.Stay with the person until professional help arrives.Try to remove any weapons, medications, or other potentially harmful objects. If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988. Click here for more links and local resources. Summary Schizophrenia and drug-induced psychosis are conditions that can both lead to delusions and hallucinations. However, they are not the same. Schizophrenia and drug-induced psychosis have different symptoms, diagnostic criteria, and treatments. There is a lack of research on how to treat and manage drug-induced psychosis, but common treatments include antipsychotic medications. Last medically reviewed on September 29, 2022Mental HealthSchizophreniaPsychology / Psychiatry 6 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Beckmann, D., et al. (2019). Substance-induced psychosis in youth.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8961695/Calabrese, J., et al. (2022). Psychosis.https://www.ncbi.nlm.nih.gov/books/NBK546579/Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR). (2022).http://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596Fiorentini, A., et al. (2021). Substance-induced psychoses: An updated literature review.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8732862/Hany, M., et al. (2022). Schizophrenia.https://www.ncbi.nlm.nih.gov/books/NBK539864/Murrie, B., et al. (2020). Transition of substance-induced, brief, and atypical psychoses to schizophrenia: A systematic review and meta-analysis.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7147575/FEEDBACK:Medically reviewed by Yalda Safai, MD, MPH — By Mathieu Rees on September 29, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? 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