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Psychotic disorder caused by the ingestion of psychoactive substances
Medical expert of the article
Last reviewed: 07.07.2025
Psychotic symptoms, especially delusions and hallucinations, may result from the use of a wide range of substances, including alcohol, amphetamines, marijuana, cocaine, hallucinogens, inhalants, opioids, phencyclidine, and some sedatives and anxiolytics. The diagnosis is established if symptoms begin within 1 month or less of intoxication or withdrawal of the substance involved and after other psychotic disorders have been excluded. Because symptoms may overlap with those of transient psychotic disorder, schizophreniform disorder, acute episodes of mania, or schizophrenia, distinguishing between these conditions may be difficult. Diagnosis may require several days of observation. Treatment may vary depending on the substance involved. Hallucinogen and phencyclidine psychoses may not respond adequately to antipsychotics. A supportive approach with a reassuring, structured, and protective environment is preferred. Agitation is best treated with short-acting benzodiazepines such as lorazepam, given orally or intramuscularly.
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