Can alcohol cause psychosis? What you should know & treatment options

Understanding healthy vs unhealthy coping mechanisms is vital, especially considering how alcohol, an unhealthy choice, contributes to various mental health disorders. These disorders range from anxiety and depression to aggression and, in severe cases, psychosis.

Alcohol-induced psychosis is a significant disturbance in mental health often stemming from persistently high levels of consumption. This article will delve into the relationship between alcohol and psychosis, highlighting the signs of alcohol-induced psychosis and the available treatment options.

The Link between Alcohol and Psychosis

Alcohol-related psychosis is a serious mental health condition that can occur due to alcohol abuse, alcohol withdrawal, or dependence. It affects a small percentage of the general population, with a lifetime prevalence of 0.4%, but the risk is higher in individuals with alcohol dependence, where it affects 4% of the population[1].

If diagnosed with alcohol-related psychosis, the chances of being re-admitted are high at 68%, and there is a 37% chance of co-morbidity with other mental disorders[1]. The condition can have long-term consequences, with patients having a 5% to 30% risk of developing a chronic schizophrenia-like syndrome[1].

Heavy and prolonged alcohol consumption can cause acute intoxication and changes in the brain, leading to psychotic symptoms such as hallucinations, delusions, and disordered thinking, which can impair daily functioning. Alcohol can trigger psychotic disorders or worsen an existing psychotic disorder, and people with bipolar disorder [2] or schizophrenia[3] are particularly susceptible to alcohol-related psychosis.

Types of Alcohol-Induced Psychosis

There are two types of alcohol psychosis. But there are other psychosis conditions that are related to alcohol withdrawal, and some others related to nutritional deficiencies caused by heavy alcohol consumption. Nonetheless, most of them are related to alcohol poisoning[4].

Alcohol Psychosis Types

• Alcoholic Paranoia or Alcohol-Induced Psychotic Disorder - This is the most common type of alcohol psychosis, which causes false belief and suspicion. Especially found in male alcoholics, who believe that their spouse is cheating on them or that their friends are plotting against them.
• Alcohol Hallucinosis - This type of alcohol psychosis is characterized by auditory hallucinations, such as hearing voices. This condition closely resembles other psychiatric disorders, such as paranoid schizophrenia, and is often misdiagnosed as such.

Alcohol-Related Psychosis Types

• Delirium - Often known as Alcohol Withdrawal Psychosis, Delirium Tremens occurs after four to seven days of cessation of alcohol consumption. It is characterized by agitation, confusion, fever, and/or hallucinations. This is the most common type of alcohol-induced psychosis, with a prevalence rate of about 1% [4].
• Alcohol Intoxication - On rare occasions, people with mild to moderate alcohol intoxication might experience alcohol psychosis symptoms which can last for a few hours. Possible causes for this condition may be related to hypoglycemia or other metabolic disorders, organic brain syndromes, and the use of stimulants or other psychotropic substances.
• Wernicke-Korsakoff Syndrome - This type of psychosis is caused by long-term damage to the brain due to thiamine deficiency. It is usually seen in individuals with chronic alcoholism, and the primary symptom of this condition is amnesia.

Who are Most at Risk of Alcohol-Induced Psychosis?

Chronic alcohol use disorder, substance abuse, and/or excessive alcohol consumption significantly increase the risk of experiencing alcohol-induced psychosis [1]. The risk is even higher in working-age men who started drinking at a young age, have low socioeconomic status, are unemployed or living on their pension, or live alone[1]. Paternal Alcohol, mental illness, and genetic factors may also contribute to the development of alcohol-induced psychosis [1].

Studies have found that people with this condition are much more likely to be anxious, depressed, and even think about suicide. Furthermore, they may unexpectedly become violent or aggressive [1].

How to Treat Alcohol-Induced Psychosis

Alcohol-induced psychosis is a serious condition that requires prompt medical attention. Here are some effective ways to treat alcohol-induced psychosis[1]:

• Stabilize the patient: The first priority is to stabilize the patient by monitoring their airway, breathing, and vital signs. If necessary, sedation may be used to manage symptoms of acute psychosis or alcohol withdrawal.
• Use medications: Neuroleptics like haloperidol, benzodiazepines like lorazepam, and atypical antipsychotics like ziprasidone and olanzapine can help manage symptoms of acute psychosis.
• Consider physical restraints: In some cases, physical restraints may be necessary to ensure the safety of the patient and medical staff.
• Assess for suicidality: Patients with alcohol-induced psychosis should be evaluated for suicidality, as it is associated with higher rates of suicidal behavior.
• Cognitive behavior therapy: In addition to medication management, cognitive behavior therapy (CBT) can effectively treat depressive and anxiety symptoms that often accompany alcohol-induced psychosis. CBT can help patients develop coping strategies and learn new ways to manage their emotions and behavior.

Here is a quick 10 question addiction test.

Conclusion

Alcohol can cause psychosis in both short and long-term alcohol abuse. However, the condition can be treated if the patient can abstain from Alcohol. Without proper treatment and the will of the patient, the chances of recurring psychotic episodes are exceedingly high[1]. It is, therefore, essential for patients to seek help from mental health professionals to manage the symptoms and underlying conditions associated with alcohol-induced psychosis. Patients can regain their mental well-being and lead productive lives with proper treatment.

FAQ

References

1. Alcohol-Related Psychosis - StatPearls - NCBI Bookshelf
2. Bipolar Disorder and Alcoholism
3. Facts about Schizophrenia
4. Alcohol-related Disorders - ScienceDirect