What Is Alcoholic Psychosis?

What Is Alcoholic Psychosis?

Alcoholic psychosis—also called alcohol hallucinosis—is a somewhat rare condition that afflicts people with an alcohol use disorder. During or after a significant period of heavy drinking, the individual will experience auditory hallucinations, fear, paranoia, and delusions.

It’s common for this condition to be confused with delirium tremens or schizophrenia because many of the symptoms overlap.1 However, some distinguishing features of alcohol-induced psychosis make it possible to diagnose alcoholic psychosis correctly.

Learn what may cause this form of psychosis, who is likely to experience it, the traits that distinguish it from other conditions with similar effects, and options for treatment. 

What Causes Alcoholic Psychosis?

There’s no consensus on what causes this condition, although several theories exist:2

  • Hallucinations may be caused by the alteration of dopamine receptors in patients with alcohol use disorder.
  • Hallucinations may result from a lower level of serotonin (due to amino acid abnormalities) on dopamine activity.
  • Blood-flow abnormality in specific regions of the brain may have something to do with why hallucinations occur.

Some experts believe that a thiamine deficiency may contribute to this condition.3

Who is Most Likely to Be Diagnosed with Alcoholic Psychosis?

Alcohol-induced psychosis is most common in:2

  • Men of working age
  • People who developed a dependence on alcohol at an early age
  • Those with a low socioeconomic status
  • The unemployed or those who live on a pension
  • People who live alone

There may also be a genetic predisposition to developing this kind of psychosis.

How Is This Condition Different From Schizophrenia?

Alcohol-induced psychosis and schizophrenia are clinically similar in symptoms, so it’s often difficult to distinguish between the two conditions. However, the primary differentiating factor is that psychosis caused by alcohol follows a period of heavy drinking, with the symptoms usually ceasing once the individual abstains. Symptoms of schizophrenia are not related to alcohol consumption, even though people with schizophrenia are vulnerable to developing a substance use disorder.

There are also some distinct characteristics attributed to alcohol-induced psychosis that allows for a more accurate diagnosis. This condition differs from schizophrenia in the following ways: 4

  • It develops later in life compared to schizophrenia
  • It shows more symptoms of anxiety and depression than schizophrenia
  • Those affected appear less disorganized than those with schizophrenia
  • Those affected demonstrate better judgment and insight
  • Those who experience this condition are not as functionally impaired as those diagnosed with schizophrenia.

How Is Alcoholic Psychosis Different From Delirium Tremens (DT)?

Delirium Tremens is a common symptom of severe alcohol withdrawal that can develop within 24-72 hours of the initial cessation of drinking.5 Comparatively, alcohol psychosis can begin while the individual is still drinking or up to 24 hours after drinking has stopped.

The comparison of alcoholic psychosis to DT is likely based on the common assumption that hallucinations accompany severe alcohol withdrawal. However, hallucinations rarely occur with DT, and they are primarily visual if they do.5 The hallucinations that occur with alcohol-induced psychosis are typically auditory.

It’s also been observed that those who experience DT with alcohol withdrawal have clouded consciousness, while those who experience psychosis caused by alcohol are generally clear mentally. 

What are Treatment Options for Alcohol-Induced Psychosis? 

Most of the time, hallucinations stop when the individual abstains from alcohol. However, some patients still hallucinate after they stop drinking, while others continue to drink without experiencing any psychosis symptoms.6

Aside from abstinence, treatment may include antipsychotic medications, benzodiazepines, thiamine (Vitamin B1), and electroconvulsive therapy. Research has shown the most successful approach to be first-generation antipsychotics and standard alcohol withdrawal treatments.7

Don’t Wait to Get Help For an Alcohol Use Disorder

Chronic alcohol use can lead to serious health risks. And the longer you put off getting help, the more difficult it is to heal. Taking the first step is difficult, but sobriety becomes easier to navigate when you have a support system in place.

At Clear Life Recovery, we will welcome you into our supportive community, where your success in sobriety is our priority. Our caring, professional staff members are experts in helping you overcome your alcohol dependency and create a sober life. To learn more about our services and programs, contact us today!

[1] https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1360-0443.1989.tb00549.x
[2] https://www.ncbi.nlm.nih.gov/books/NBK459134/
[3] https://emedicine.medscape.com/article/289848-treatment#d8
[4] https://emedicine.medscape.com/article/289848-overview
[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6286444/
[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3830167/
[7] https://academic.oup.com/alcalc/article/53/3/259/4627701