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Are My Medications Causing Delusions? The Scary Truth About Drug-Induced Psychosis

Last Updated on January 6, 2025 by Carol Gillette

Alternative to Meds Editorial Team
Medically Reviewed by Dr Samuel Lee MD

In the United States, as in many other areas of the world, prescription medications have become a cornerstone of the healthcare system. Unfortunately, any benefits of these medications often come with a hidden cost: side effects that can range from mild discomfort to severe, life-altering complications. One particularly concerning side effect of prescription drugs that some people can experience is delusions.

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In a mental health crisis, diagnoses are typically rushed, and based on limited clinical data. Proper diagnoses are advantaged by close examination of diet & nutritional factors, past exposure to toxic chemicals, and other important points before prescribing heavy drugs over long periods of time. In addition, if delusions occurred after a prescription drug was introduced, it is likely that the actual root causes of symptoms has been neglected and a compounded problem can result.

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What Is Drug-Induced Psychosis?

Prescription drug-induced psychosis, sometimes called medication-induced psychosis, occurs when a person experiences psychotic symptoms as a direct result of using a prescription medication. Drug-induced psychosis can happen when a new medication is introduced or when a medication has been used over a long period of time.

Symptoms of Drug-Induced Psychosis (DIP)

Symptoms of psychosis can be caused by prescription drugs. And alarmingly, the number of prescription drugs associated with drug-induced psychosis is increasing year over year.1,2,14

Symptoms of drug-induced psychosis can include:
  • >Delusions, hallucinations
  • Disturbed feelings & emotions
  • Disorganized speech, incoherence, poverty of speech
  • Unusual behaviors
  • Cognitive impairment
  • Schizophrenic symptoms, often leading to misdiagnosis

Delusions

  • “Grandiose delusions” may include unfounded beliefs that someone possesses exceptional talent, has made a significant discovery, or holds a significant status. Another example is that the person believes they have considerable power or knowledge or can directly communicate with a deity.
  • Delusional jealousy, or beliefs that an intimate partner has been unfaithful, even if that occurrence is impossible.
  • Paranoid or persecutory delusions, beliefs that someone is being conspired against, harmed, attacked, or harassed.
  • Somatic delusions, beliefs of something wrong with one’s body, such as a missing part, or an experience of strange sensations throughout the body.
  • Reference delusions, the belief someone can read other people’s thoughts or that another person’s actions are directed against them.
  • Bizarre delusions, when a person believes in a phenomenon that is impossible to happen in a normal life.
  • Mixed delusions, when a person experiences a mix of different types of delusions.
  • Hallucinations are perceptions that are not really there, but they seem real to the person. Examples might include seeing or hearing a cat that is not really there, or hearing voices. These perceptions can seem hyper real to the person experiencing them.

Disturbed feelings & emotions

  • Confusion
  • Agitation or aggression
  • Anger
  • Paranoia
  • Lack of interest in activities

Unusual behaviors, cognitive impairment

  • Incoherent speech
  • Trouble remembering things
  • Difficulty maintaining hygiene or other routine daily activities
  • Inappropriate behaviors
  • Anger for no obvious reason
  • Unusual inactivity, lethargy
  • Becoming completely unaware of the surrounding environment

How Long Will Drug-Induced Psychosis Symptoms Last?

For many people, the psychotic symptoms they are experiencing will only last while the prescription drug is in the system. After withdrawal, the hallucinations, delusions, and other symptoms typically end. In some cases, drug-induced psychosis will last longer, and in some cases can result in permanent damage.11

Risk Factors to Consider

Many factors can increase a person’s risk of developing prescription drug-induced psychosis, such as taking medications at high doses or for extended periods or combining multiple medications with other substances.2

Toxic exposures, stress or recent traumatic events can also play a role, as well as age, as both adolescents and older adults may face higher risks. The rate of drug metabolism is another variable to consider.

Genetic factors, and those present in a person’s family history may indicate sensitivity to specific medications and can also predispose individuals to psychosis.

What Type of Prescription Drugs Can Cause Drug-Induced Psychosis?

While prescription drugs can affect individuals differently, some medications are more commonly related to medication-induced psychotic disorders. More detailed information on these drugs is provided below the drug list.

Medications that can cause drug-induced psychosis can include:
  • Anti-Parkinson drugs such as Levadopa
  • Antipsychotics
  • Stimulants such as cocaine, methamphetamine, Modafinil
  • Antidepressants such as SSRIs, SNRIs, tricyclics, etc.
  • Opioids, pain relievers
  • Heart medications
  • Anti-inflammatory drugs such as Prednisone, hydrocortisone, etc.

Anti-Parkinson Drugs

Parkinson’s disease is a chronic, progressive neurodegenerative disease that is often treated with medication. These drugs are dopaminergic. Anti-Parkinson drugs are associated with the highest risk of prescription-induced psychosis, with symptoms developing in up to 60% of Parkinson’s patients, especially older patients who require higher doses of the drugs.3

Commonly prescribed medications for Parkinson’s disease are:
  • Levodopa
  • Dopamine agonists like pramipexole (Mirapex), ropinirole (Requip), and rotigotine (Neupro).
  • MAO-B inhibitors like selegiline (Eldepryl or Zelapar) and rasagiline (Azilect).
  • Anticholinergics like benztropine (Cogentin) and trihexyphenidyl (Artane).
  • Amantadine
  • Adenosine A2A receptor antagonists like istradefylline (Nourianz).

Antipsychotics

As Chouinard’s research coconcludes, antipsychotics remain the first choice in treating psychotic disorders. However, long-term use or abrupt withdrawal are both associated with psychosis symptoms. Antipsychotics cause a condition known as dopamine supersensitivity, cited as the most likely reason for these drug-induced psychosis phenomena.15

Correctly tapering off antipsychotics combined with non-toxic ways to address symptoms of schizophrenia or misdiagnosed schizophrenic symptoms is the best way forward. But medical supervision is highly recommended to keep the path as clear and as unencumbered as possible.

Commonly prescribed antipsychotics include:
  • Seroquel
  • Abilify
  • Risperidone
  • Clozaril

Stimulants

Stimulants are commonly prescribed for attention deficit hyperactivity disorder (ADHD), narcolepsy, depression, and more. Typically, taking these medications in high doses, with prolonged use can increase a person’s risk for psychosis.4

Common prescription stimulants that may cause psychosis include:
  • Amphetamines such as Adderall, Dexedrine, Evekeo, and Vyvanse.
  • Methylphenidate such as Ritalin, Concerta, Metadate, and Daytrana.
  • Dexmethylphenidate, such as Focalin.
  • Modafinil such as Provigil.
  • Armodafinil such as Nuvigil.

Antidepressants

Antidepressants are primarily used to treat depression and anxiety disorders, but some can potentially lead to psychosis, especially if a person is taking a high dose, polypharmacy, or has untreated contributing factors.5

These are the types of antidepressants that have been associated with an increased risk of psychosis:
  • Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), and escitalopram (Lexapro).
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine (Effexor XR), duloxetine (Cymbalta), and desvenlafaxine (Pristiq).
  • Tricyclic antidepressants (TCAs) such as amitriptyline, nortriptyline (Pamelor), imipramine (Tofranil), and desipramine (Norpramin).
  • Monoamine Oxidase Inhibitors (MAOIs) such as phenelzine (Nardil), tranylcypromine (Parnate), and isocarboxazid (Marplan).
  • Trazodone
  • Bupropion (Wellbutrin)

Opioids and Pain Relievers

Opioids can cause psychosis for some individuals, thought due to their effects on neurotransmitters. Many people use opioids for long periods, which can lead to neurotoxicity and interaction with other drugs, potentially damaging brain cells and disrupting normal brain function.6

The most common opioids and pain relievers that have been associated with psychotic symptoms are:
  • Oxycodone like OxyContin or Percocet.
  • Hydrocodone like Vicodin or Norco.
  • Morphines like MS Contin and Kadian.
  • Fentanyl like Duragesic and Actiq.
  • Codeine
  • Tramadol
  • Diphenhydramine (Benadryl), although it is primarily over-the-counter (OTC), high doses can lead to confusion, agitation, and hallucinations.

Combining any of these medications with alcohol, sedatives, or other drugs, either prescription or non-prescription, can exacerbate the risk of psychosis.

Heart Medications

Heart medications can be prescribed when someone suffers from a variety of heart problems, including heart arrhythmias, atrial fibrillation, and a variety of other symptoms and diseases that can lead to heart failure. In some patients, heart medications may cause psychosis and related symptoms.7

A few heart medications associated with psychotic symptoms are:
  • Digoxin, mainly used for heart failure and atrial fibrillation<
  • Antiarrhythmics, such as quinidine or procainamide, which are used for heart arrhythmias
  • Beta-blockers and calcium channel blockers that are used for hypertension, angina, and heart failure, such as propranolol, metoprolol, atenolol, verapamil, and diltiazem
  • ACE inhibitors and ARBs like enalapril, lisinopril, losartan, and valsartan, commonly used for hypertension and heart failure
  • Statins for lowering cholesterol, like atorvastatin, simvastatin, and rosuvastatin

Corticosteroids

Corticosteroids are anti-inflammatory medications used to treat asthma, rheumatoid arthritis, and lupus. The occurrence of psychiatric reactions associated with corticosteroid use varies widely, which is indicative of a highly unpredictable medication. They are often influenced by dosage amount, treatment duration, and individual health and risk factors, but corticosteroids have the potential to cause psychosis.8

Commonly used corticosteroids are:
  • Prednisone
  • Hydrocortisone
  • Dexamethasone
  • Methylprednisolone
  • Betamethasone<

Why Does Drug-Induced Psychosis Occur?

Prescription medications can sometimes lead to psychosis due to their impact on brain chemistry and function. One key factor is how these drugs affect neurotransmitter systems, including dopamine, serotonin, norepinephrine, or others. These disruptions can lead to delusions and hallucinations.

Drug interactions can also be a contributing factor, such as combining medications or other substances like alcohol or OTC drugs. High doses or overdoses can also overwhelm the brain’s ability to regulate mood and perception, resulting in psychotic symptoms.9

In addition, some side effects are more likely to occur due to the personal health of the person taking the medications, such as their body’s ability to process medications, pre-existing health conditions, poor nutrition, toxic exposures, and genetic or other biological factors.

Drug-Induced Psychosis FAQs

Whether you have experienced medication-induced psychosis or are looking for signs and symptoms in a loved one, these frequently asked questions can help provide more clarity.

How Can You Tell If Drug-Induced Psychosis Is Happening?

Identifying drug-induced psychosis is about understanding what the symptoms are, when they began, and thorough investigation of root causes for symptoms that may have been neglected in the past. After beginning a medication, if they begin experiencing hallucinations, delusions, or paranoia, if their thinking becomes more disorganized, if they are increasingly agitated or irritable, or if they have mood swings without a clear trigger, then a medication-induced psychotic disorder event may be occurring.

If you are concerned about medication-induced psychosis, it is important to seek professional help as soon as possible.

It is important to be aware that stopping or discontinuing any medication suddenly can worsen symptoms. At this point, it is of great benefit to understand the full history of the presentation of psychotic features. A person can then begin recovery which will likely include a medically supervised tapering or reduction program, and addressing underlying contributing factors which were not handled in the past.

Who Is at Risk for Developing Prescription Drug-Induced Psychosis?

Certain factors can increase the risk of developing psychosis, such as high dosage or prolonged use of medications, drug interactions, and other factors. Additionally, age, genetic factors, stress, history of substance misuse, toxic exposures, nutritional deficiencies, a person’s general health and habits, and other medical conditions are all good candidates for exploring best treatment options.

How is Drug-Induced Psychosis Diagnosed?

Drug-induced psychosis is diagnosed by reviewing a person’s medication history, such as looking for changes in prescriptions and assessing for symptoms like hallucinations or delusions. A professional will explore other potential causes of psychosis by conducting exams and lab tests.

Is Drug-Induced Psychosis Permanent?

Generally, no. Drug-induced psychosis is typically not permanent, and the duration and severity of the symptoms will vary among patients. Most cases resolve once the medication responsible for the psychosis is safely discontinued. However, some people may experience lingering effects and require extended treatment to fully recover.

The Prevalence of Prescription Medication in America

Nearly 70% of American adults have reported they are taking at least one prescription medication per day. That is a 14% increase from 2019. Of those medications, the most commonly prescribed are antidepressants and antianxiety medications, along with chronic condition management medications for things like hypertension, diabetes, and high cholesterol.10-13

As you can see, the growing number of prescription medications — including those taken daily – has led to growing concern about the side effects that come with them. Psychosis is a severe mental health event that can be dangerous for the individual and others. People experiencing psychosis due to prescription medication can behave unpredictably and become threatening to others, increasing the risk of harm for all involved. Worse, people experiencing psychosis may harm themselves. It is crucial to both seek immediate help for psychosis and reduce the chances of medication-induced psychosis by taking only life saving medications.

Alternative to Meds Center Services for Drug-Induced Psychosis

Alternative to Meds Center is an Arizona state-licensed residential treatment facility, and we take pride in offering inpatient mental health, medication reduction, addiction treatment, and adjacent therapies. Our approach integrates alternative, holistic, and psychotherapeutic modalities to support comprehensive wellness. treatment for drug induced delusionsSome of the methods we use for medication-induced psychotic disorders include medication tapering and neurotransmitter therapy as part of a customized treatment plan.

Some of the services for addressing drug-induced psychosis at Alternative to Meds Center include:

  • 24/7 care
  • Medically monitored medication tapering
  • Cleansing neurotoxins from the body, environmental medicine
  • Neurotransmitter therapy
  • Orthomolecular medicine, correction of diet
  • Correction of nutritional deficiencies
  • Physical exercise
  • Physical therapies

Medication Tapering

Abruptly stopping your medication especially in a non-medical environment is absolutely not recommended. Both drug use and drug withdrawal can result in psychosis and each requires specialized steps to safely treat. We utilize safe and gentle methods for medication withdrawal. Tapering is all about allowing the body the time it needs to adjust to each new dose until the medication can safely be eliminated from the system.

Learn More About Medication Tapering

Neurotransmitter Therapy

Neurotransmitter rehabilitation therapy involves restoring neurotransmitter function through the use of probiotics and prebiotics, amino acid supplementation, dietary and nutritional adjustments, removal of neurotoxins and heavy metals, psychological therapies, and physical therapies for relief.

Learn More About Neurotransmitter Therapy

Individualized Medication Recovery Treatment Plans

Each client receives a customized treatment plan to address their unique needs. Upon admission to Alternative to Meds Center, each person undergoes lab testing and medical assessments to evaluate their needs. This may involve medication tapering, withdrawal management, body detoxification techniques, and other treatments designed to make the transition off prescription drugs as comfortable and smooth as possible.

Learn More About Our Individualized Treatment Plans

Holistic Recovery from Prescription Drug-Induced Psychosis

Prescription drug-induced psychosis is a serious side effect that should receive prompt attention to prevent a tangle of life-altering complications. With our holistic treatment approach, individuals can safely access the therapies that will help, and learn the skills they need to recover and lead a healthier, drug-free life.

Reach out to Alternative to Meds Center today to learn more about the risks of psychosis from prescription medications and how our residential treatment program can help you find recovery.

1 (800) 301-3753 for help with Drug-Induced Delusions

Sources:

1. Substance Abuse and Mental Health Services Administration, (2016). Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US). Table 3.20, DSM-IV to DSM-5 Psychotic Disorders. [cited 2025 Jan 7]

2. Fiorentini, A., Cantù, F., Crisanti, C., Cereda, G., Oldani, L., & Brambilla, P. (2021). Substance-Induced Psychoses: An Updated Literature Review. Frontiers in psychiatry, 12, 694863. [cited 2025 Jan 7]

3. Forsaa, E. B., Larsen, J. P., Wentzel-Larsen, T., Goetz, C. G., Stebbins, G. T., Aarsland, D., & Alves, G. (2010). A 12-year population-based study of psychosis in Parkinson disease. Archives of neurology, 67(8), 996–1001. [cited 2025 Jan 7]

4. Björkenstam, E., Pierce, M., Björkenstam, C., Dalman, C., & Kosidou, K. (2020). Attention Deficit/Hyperactivity Disorder and risk for non-affective psychotic disorder: The role of ADHD medication and comorbidity, and sibling comparison. Schizophrenia Research, 218, 124-130. [cited 2025 Jan 7]

5. Bangwal, R., Bisht, S., Saklani, S., Garg, S., & Dhayani, M. (2020). Psychotic disorders, definition, sign and symptoms, antipsychotic drugs, mechanism of action, pharmacokinetics & pharmacodynamics with side effects & adverse drug reactions: Updated systematic review article. Journal of Drug Delivery and Therapeutics, 10(1), 163-172. [cited 2025 Jan 7]

6. Gallagher R. (2007). Opioid-induced neurotoxicity. Canadian family physician Medecin de famille canadien, 53(3), 426–427. Retrieved August 7, 2024. [cited 2025 Jan 7]

7. Huffman, J. C., & Stern, T. A. (2007). Neuropsychiatric consequences of cardiovascular medications. Dialogues in clinical neuroscience, 9(1), 29–45. [cited 2025 Jan 7]

8. Kazi, S. E., & Hoque, S. (2021). Acute Psychosis Following Corticosteroid Administration. Cureus, 13(9), e18093. [cited 2025 Jan 7]

9. Kapur, S., Mizrahi, R., & Li, M. (2005). From dopamine to salience to psychosis—Linking biology, pharmacology and phenomenology of psychosis. Schizophrenia Research, 79(1), 59-68. [cited 2025 Jan 7]

10. Health Policy Institute. (2022). Prescription Drugs | Health Policy Institute | Georgetown University. Health Policy Institute. [cited 2025 Jan 7]

11. Chen WL, Hsieh CH, Chang HT, Hung CC, Chan CH. The epidemiology and progression time from transient to permanent psychiatric disorders of substance-induced psychosis in Taiwan. Addict Behav. 2015 Aug;47:1-4. doi: 10.1016/j.addbeh.2015.02.013. Epub 2015 Feb 21. PMID: 25841087. [cited 2025 Jan 7]

12. Ayano G, Demelash S, Yohannes Z, Haile K, Tulu M, Assefa D, Tesfaye A, Haile K, Solomon M, Chaka A, Tsegay L. Misdiagnosis, detection rate, and associated factors of severe psychiatric disorders in specialized psychiatry centers in Ethiopia. Ann Gen Psychiatry. 2021 Feb 2;20(1):10. doi: 10.1186/s12991-021-00333-7. PMID: 33531016; PMCID: PMC7856725. [cited 2025 Jan 7]

13. Ham S, Kim TK, Chung S, Im HI. Drug Abuse and Psychosis: New Insights into Drug-induced Psychosis. Exp Neurobiol. 2017 Feb;26(1):11-24. doi: 10.5607/en.2017.26.1.11. Epub 2017 Feb 7. PMID: 28243163; PMCID: PMC5326711.[cited 2025 Jan 7]

14. AlSalem M, AlHarbi MA, Badeghiesh A, Tourian L. Accuracy of initial psychiatric diagnoses given by nonpsychiatric physicians: A retrospective chart review. Medicine (Baltimore). 2020 Dec 18;99(51):e23708. doi: 10.1097/MD.0000000000023708. PMID: 33371117; PMCID: PMC7748330.[cited 2025 Jan 7]

15. Chouinard G, Samaha AN, Chouinard VA, Peretti CS, Kanahara N, Takase M, Iyo M. Antipsychotic-Induced Dopamine Supersensitivity Psychosis: Pharmacology, Criteria, and Therapy. Psychother Psychosom. 2017;86(4):189-219. doi: 10.1159/000477313. Epub 2017 Jun 24. PMID: 28647739. [cited 2025 Jan 7]


This content has been reviewed and approved by a licensed physician.

Dr. Samuel Lee

Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente.  He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.

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