Alcohol & Health
Treatment
Helping Alcoholics
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Medically Reviewed by Dr P. E. Pancoast, MD
Alcohol-induced psychosis occurs in individuals who experience:
Healthcare professionals refer to alcohol-induced psychosis as a secondary psychosis. This means that substance abuse is associated with psychosis symptoms. Primary psychosis means that a mental health (psychotic) disorder such as schizophrenia causes symptoms.
According to the DSM-5, someone diagnosed with alcohol-induced psychotic disorder experiences significant hallucinations or delusions.
These delusions start during or immediately after alcohol intoxication or withdrawal. In addition, no other psychotic disorder can be responsible for the psychotic episode.
Alcohol is a chemical compound that interacts with many neurotransmitters, including serotonin and dopamine. These are little chemicals that attach to different parts (receptors) of the brain and central nervous system (CNS).
Alcohol triggers changes in the functions of cells, cell membranes, and organs (including your brain). Therefore, people with an alcohol use disorder can develop hallucinations or delusions. Your auditory system could also be affected, causing these symptoms.
Quitting drinking through healthy means and with support will help people who experience psychosis.
A Dutch literature review published in 2015 observed that 4% of people with alcohol dependence experienced an alcohol-related psychotic disorder. Only 0.4% of the general population experienced the disorder. The highest rate is in working-age men.
Alcohol-induced psychosis refers to delusions or hallucinations that result from heavy drinking. They cannot be the result of any other pre-existing mental health condition.
There are three types of alcohol-induced psychosis:
Delirium tremens psychosis occurs during alcohol withdrawal syndrome. Individuals will begin to experience delirium within 4 to 7 days of stopping alcohol consumption.
Symptoms of the condition will include:
Individuals with this condition require medical support. A supervised program can help them detox. Sedatives like benzodiazepines may also be necessary.
If left untreated, delirium tremens psychosis can become life-threatening. Untreated DTs have a mortality rate of over 25%, while medically treated DTs have a mortality rate of around 5%.
Alcohol poisoning psychosis is sometimes called acute intoxication. It occurs after an individual consumes a very large amount of alcohol. Sometimes, symptoms can occur while the person is intoxicated. Other times they occur when the body is clear of alcohol.
People can experience severe aggression or psychotic reactions for several hours. Often, they won't remember anything (amnesia) following the psychotic episode.
Other factors such as hypoglycemia (low blood sugar) or psychotropic drugs (e.g., stimulants) can increase the risk of developing alcohol poisoning and alcohol poisoning psychosis.
Alcoholic hallucinosis occurs after years of chronic alcohol abuse. It shares some symptoms with delirium tremens psychosis.
For example, psychotic symptoms can include:
Hallucinations are often auditory with alcoholic hallucinosis. Mood disturbances are common as well.
The periods of psychoses last longer with alcoholics. They may last hours, days, or weeks. This makes alcoholic hallucinosis seem like paranoid schizophrenia. However, there has been no genetic connection shown between the two conditions.
Alcohol-induced psychosis consists of three different types, as mentioned earlier. Warning signs of the condition can appear either during or after alcohol consumption.
Some warning signs of alcohol-induced psychosis include:
Alcohol-induced psychosis can mimic schizophrenia. Especially chronic alcoholic hallucinosis. However, there are some differences in how the two conditions present.
Alcohol-induced psychosis often happens at an older age. They may experience stronger anxiety and depression. Insight and judgment may also be better in individuals with alcohol-induced psychosis.
No. Alcohol does not cause schizophrenia. There is no evidence to support that the two conditions have a common genetic basis.
However, alcohol hallucinosis is quite similar to paranoid schizophrenia. Alcohol and drug use may cause psychosis in those susceptible to developing schizophrenia.
Individuals who have received an alcohol-induced psychosis diagnosis face a 68% probability of readmission. 37% receive a dual diagnosis (co-occurring mental illness).
Wernicke-Korsakoff syndrome (WKS) refers to a thiamine (vitamin B1) deficiency.
Excessive long-term alcohol consumption can cause thiamine loss in the body. This leads to brain damage and can cause hallucinations and memory loss. It can also damage your liver, gastrointestinal tract, and pancreas.
Wernicke encephalopathy is the acute version and symptoms include:
Korsakoff syndrome is the chronic (long-lasting) version and symptoms include
These conditions may present the same symptoms as alcohol-induced psychosis. However, your mental abilities will continue to deteriorate with Wicke-Korsakoff Syndrome.
Wicke-Korsakoff syndrome is caused directly by thiamine deficiency. Memory loss is often an indicator of WKS.
Alcohol-induced psychosis is life-threatening. It can pose risks for the individual suffering from the psychotic episode and those nearby.
Individuals with the condition can become violent and require physical restraints. Higher rates of suicidal behaviors have been associated with alcohol-induced psychosis.
The mortality risk for those with untreated delirium tremens psychosis is signifcant. Historically, untreated DTs have had a mortality rate of around 35%. Seizures, cardiac arrhythmia, and many more clinical symptoms can arise.
Fortunately, if individuals receive addiction treatment and stop drinking alcohol, they have a high chance of recovery.
Treatment options are available for alcohol-induced psychosis.
If you have an alcohol use disorder and a mental health problem, it is essential to seek help for both conditions.
Clinicians will consider different approaches depending on an individual’s airway, breathing, and vital signs. If sedation is necessary, clinicians may administer neuroleptics (antipsychotics) such as haloperidol or ziprasidone.
Benzodiazepines, like lorazepam, may be another treatment strategy for alcohol withdrawal symptoms and seizures.
For individuals with AUD, quitting alcohol is mandatory if they are to recover to a normal life. Otherwise they are likely to develop a chronic syndrome and multiple recurrent illnesses. Inpatient and outpatient treatment can help you quit.
These programs include supervised detox processes, provide medical support, and even organize support groups to help individuals reach recovery.
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