Types of Alcohol-Induced Psychosis
While drinking alcohol does cause symptoms like decreased inhibition or impaired coordination, it rarely causes symptoms of psychosis. Alcohol-induced psychosis typically occurs due to secondary effects of alcohol use — not from alcohol use itself. These effects can include alcohol hallucinosis, delirium tremens and Wernicke-Korsakoff syndrome.
Psychosis From Alcoholic Hallucinosis
Alcoholic hallucinosis is a fairly uncommon outcome of alcohol abuse and is generally only seen in people who have a chronic alcohol use disorder. Alcoholic hallucinosis usually develops 12 to 24 hours after heavy alcohol consumption abruptly stops, and it can last for several days. Severe and recurrent alcohol abuse can increase the risk of developing alcoholic hallucinosis.
Psychosis from alcoholic hallucinosis is primarily characterized by auditory hallucinations, such as accusing and threatening voices, along with visual hallucinations. Delusions and mood disruptions may also occur.
Psychosis From Delirium Tremens
Psychosis from delirium tremens is a more severe diagnosis than alcoholic hallucinosis. Delirium tremens is a severe complication of alcohol withdrawal and is classified as a medical emergency, as symptoms can be life-threatening. Delirium tremens usually develops two to three days after excessive alcohol consumption concludes.
Symptoms of delirium tremens may include a significant lack of coordination, excessive sensitivity to sensory input, abrupt mood changes and elevated heart rate and respiration. Other symptoms can include delusions, hallucinations and body tremors. Seizures and alcohol withdrawal hallucinations that are extremely severe may require sedation as a part of treatment.
Delirium tremens is often fatal if left untreated, and it requires professional medical intervention. For this reason, it is critical for people going through alcohol withdrawal to be under the supervision of medical professionals in a medical detox program.
Wernicke-Korsakoff Syndrome (WKS)
Wernicke-Korsakoff syndrome (WKS) is a serious complication of heavy alcohol use and is caused by low levels of thiamine (vitamin B1). Alcohol is the main cause of Wernicke-Korsakoff syndrome in developed areas of the world, as the substance affects how thiamine is absorbed. Low thiamine levels can cause brain inflammation that creates dangerous neurological symptoms.
If treated by replacing thiamine levels, inflammation caused by Wernicke-Korsakoff syndrome can be reversed. If untreated, however, this inflammation can lead to permanent brain damage. It is during this stage of Wernicke-Korsakoff syndrome that psychosis can occur. Wernicke-Korsakoff syndrome can cause hallucinations and memory gaps that a person will fill with made-up memories called confabulations.