Login
Subscribe
Psychosis is a disorder of the mind in which a person loses some contact with reality.[1] Typical symptoms of psychosis include hallucinations (for example, seeing, hearing or smelling things that are not actually present), delusions (strongly held false beliefs that are not typical of a person’s cultural or religious background) and disorganized thoughts.[2] Such symptoms can be disturbing to patients experiencing them and their loved ones and may lead to self-harm or behaviors that harm...
Psychosis is a disorder of the mind in which a person loses some contact with reality.[1] Typical symptoms of psychosis include hallucinations (for example, seeing, hearing or smelling things that are not actually present), delusions (strongly held false beliefs that are not typical of a person’s cultural or religious background) and disorganized thoughts.[2] Such symptoms can be disturbing to patients experiencing them and their loved ones and may lead to self-harm or behaviors that harm others.
Psychosis is most commonly caused by psychiatric disorders, including schizophrenia, bipolar disorder and certain forms of major depression.[3] Other causes of psychosis include severe liver or kidney disease; certain infections, such as advanced syphilis and herpes simplex infection of the brain; inflammatory disease like systemic lupus erythematosus; neurological diseases such as Alzheimer’s disease; excessive alcohol use; and substance-use disorder involving opioids or stimulants.[4]
Importantly, numerous prescription medications and some over-the-counter drugs can cause psychotic symptoms, including hallucinations. In general, these drugs can be divided into two categories: psychotropic/neurologic drugs (those that primarily work by affecting how the brain works and, in most cases, can cause changes in mood, awareness, thoughts, feelings, behavior or pain perception) and non-psychotropic drugs (those that do not primarily work by affecting how the brain works).
Psychotropic/neurologic drugs
The list of psychotropic/neurologic drugs that can cause psychotic symptoms is lengthy and includes certain antidepressants, antiseizure medications, benzodiazepines, insomnia drugs, opioid analgesics, Parkinson’s disease drugs and stimulants.[5],[6],[7] Table 1 below lists examples of such drugs; note that this table is not all-inclusive.
Notably, psychotic symptoms due to benzodiazepines are most likely to occur if the drugs are discontinued too quickly, which can trigger withdrawal symptoms.[8]
Table 1. Examples of Oral Psychotropic/Neurologic Drugs That Can Cause Psychosis
| Drug Category | Generic Drug Name (Brand Name[s]) |
|---|---|
| Antidepressants | Tricyclics
|
| Antiseizure medications |
|
| Benzodiazepines |
|
| Insomnia drugs |
|
| Opioids |
|
| Parkinson’s disease drugs |
|
| Stimulants for attention deficit hyperactivity disorder |
|
†Combination brand-name drug that contains one or more other active ingredients
*Designated as Do Not Use by Worst Pills, Best Pills News
**Designated as Limited Use by Worst Pills, Best Pills News
Non-psychotropic drugs
The list of non-psychotropic medications that can cause psychotic symptoms, such as hallucinations, includes certain anabolic steroids, particularly if abused; antibiotics; antiviral drugs; systemic (oral or intravenous) corticosteroids (also known as glucocorticosteroids); cough and cold medications; drugs for heart disease and hypertension, including abnormal heart-rhythm drugs, angiotensin-converting enzyme inhibitors, beta blockers and digoxin (LANOXIN); drugs for malaria; and histamine-2 receptor blockers, which are used to treat heartburn and other stomach-acid–related disorders.[9],[10] Table 2, below, lists examples of such drugs; note that this table is not all-inclusive.
Table 2. Examples of Oral Non-Psychotropic Drugs That Can Cause Psychosis
| Drug Category | Generic Drug Name (Brand Name[s]) |
|---|---|
| Anabolic steroids |
|
| Antibiotics |
|
| Antiviral drugs |
|
| Corticosteroids |
|
| Cough medications |
|
| Drugs for cardiovascular disease | Abnormal heart-rhythm drugs
|
| Drugs for malaria |
|
| Histamine-2 blockers |
|
†Combination brand-name drug that contains one or more other active ingredients
*Designated as Do Not Use by Worst Pills, Best Pills News
**Designated as Limited Use by Worst Pills, Best Pills News
What You Can Do
If you or a loved one experience psychotic symptoms such as hallucinations or delusions, review all of your or your loved one’s medications with a doctor to determine whether any of them may be contributing to these symptoms. Do not stop taking any prescription medication without first talking to your doctor. Be aware that other drugs not listed in this article can cause psychotic symptoms.
References
[1] National Institute of Mental Health. RAISE questions and answers. https://www.nimh.nih.gov/health/topics/schizophrenia/raise/raise-questions-and-answers. Accessed September 7, 2022.
[2] Marder S. Psychosis in adults: Epidemiology, clinical manifestations, and diagnostic evaluation. UpToDate. April 14, 2022.
[3] Ibid.
[4] Ibid.
[5] Pelak VS. Approach to the patient with visual hallucinations. UpToDate. March 29, 2019.
[6] Marder S. Psychosis in adults: Epidemiology, clinical manifestations, and diagnostic evaluation. UpToDate. April 14, 2022.
[7] Gunja N. In the Zzz zone: The effects of Z-drugs on human performance and driving. J Med Toxicol. 2013;9(2):163-171.
[8] Marder S. Psychosis in adults: Epidemiology, clinical manifestations, and diagnostic evaluation. UpToDate. April 14, 2022.
[9] Pelak VS. Approach to the patient with visual hallucinations. UpToDate. March 29, 2019.
[10] Marder S. Psychosis in adults: Epidemiology, clinical manifestations, and diagnostic evaluation. UpToDate. April 14, 2022.
