Drugs that could cause psychosis

Someone has really screwed up the screening of the trial compound if this happens.
Centrally acting 5HT2a agonist might do this, but you really should notice this activity very early in testing.

LSD

It was tested by the CIA on unsuspecting people, and there were reports of all sorts of bizarre reactions, including psychosis, years afterward.

crunchyblanket said:

I have a character who is being tried for murder. She is technically guilty, but she was acting out of psychosis, caused by a drug she took as part of a clinical trial for a pharmaceutical company. So I'm trying to find out what kinds of drugs can include psychosis as a side-effect - obviously the drug in the trial will be fictional, but I'd like it to be somewhat based in reality.

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I have a similar situation in one of my stories. Let's see, my text refers to "Levadopa, Amantadine, a 'stew of phenylalanines', 'some kind of butyrophenone analogue', and traces of Bz." Not all of those are psychosis-producing; some are antipsychotics intended to mellow the effect. Without going back and looking at my research I can say that Bz is the big actor, that will drive someone crazy all by itself.

Lil said:

LSD

It was tested by the CIA on unsuspecting people, and there were reports of all sorts of bizarre reactions, including psychosis, years afterward.

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The activity of LSD is generally attributed to its 5HT2a agonism (or partial agonism)

Drugs used to treat Parkinson's Disease can cause psychosis. Also, prolonged (as in, several years) use of amphetamines causes psychosis as well, but one dose typically wouldn't be enough.

Ritalin can cause psychosis. My brother in law was put on it as a teenager and after one dose flew into a murderous rage, tried to strangle his brother and put him in the hospital. The only thing that saved the brother was other people were around to pull my BIL off him. They took my BIL off the meds and no charges were pressed. He felt really bad afterward, as he and his brother are normally very close and get along well.

crunchyblanket said:

Ooh, now there's an interesting idea. CIA and FBI type agencies would fit perfectly into the world I'm building - although I'm not entirely sure who the UK equivalent would be. MI6? In any case, that might fit better than a pharma company...

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I swear I read an article somewhere about how lsd was tested on mentally ill patients as well, but I can't seem to find it. There is a few lines about it under history on this page though.


Edit: Some antipsychotics can also cause psychosis.

Canotila said:

Ritalin can cause psychosis. My brother in law was put on it as a teenager and after one dose flew into a murderous rage, tried to strangle his brother and put him in the hospital. The only thing that saved the brother was other people were around to pull my BIL off him. They took my BIL off the meds and no charges were pressed. He felt really bad afterward, as he and his brother are normally very close and get along well.

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Well, Ritalin is basically a type of amphetamine. It's a psychostimulant with effects similar to cocaine.

Psychomacologist said:

Well, Ritalin is basically a type of amphetamine. It's a psychostimulant with effects similar to cocaine.

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That makes sense. I'd heard that somewhere but wasn't sure enough to post it. Thanks!

Insanity defense is a hard nut to crack. And has been notably unsuccessful in drug-induced psychosis. Or for that matter, any type of psychosis. And the differences between the UK and US aren't that major here.

Although there is some differences between hallucinations and delusions, I'm not going to get that technical here. Let's say someone thinks she's Ann Boleyn. There's absolutely no dispute about this fact. It won't do her a bit of good. Because neither Ann Boleyn nor any other person can act in an illegal fashion.

So let's say that while believing she's Ann Boleyn she decides someone is Henry VIII. And my guess is Henry VIII was rather an undesirable person to be married to. So instead of a divorce, she decides to kill the guy. Because she no longer wants to be married to Henry VIII. Everybody agrees this is what happened. No dispute about the diagnosis. But it doesn't help. Because Ann Boleyn has no legal right to off her husband instead of getting a divorce.

If, however, she believes she is Ann Boleyn, she decides someone is Henry VIII, who is going to execute her, and acting in self-defense to prevent that execution, she kills the Henry VIII, at a time where she does not have a duty to retreat, or can show that a duty to retreat does not apply. At this point, she has a defense.

In other words, if a person has a delusion or a hallucination but is able to determine what is right or wrong, the delusion or hallucination only works if the person acts in accordance with legal standards.

OR

The person has no understanding of the difference between right and wrong, or lawful and unlawful, or good and bad. The classic example is that the person would have done the same act if the person had a police officer standing right next to them. Understand this is a very hard thing to convince anyone of. Or in other words, the person has absolutely no understanding of their actions.

Drug-induced delusions and hallucinations rarely rise to this level. Classic negation of this would be the person saying something like, "Cool it, it's the cops." And think how many drug-induced people have a reaction to seeing the cops or fearing the cops, even though they are having delusions or hallucinations.

Combined with this is the tox screen that's going to be needed to show the person was under the influence of a drug. If the drug shows up as a typical drug which people take for the purposes of causing psychiatric effects, people are going to assume the person took the drug voluntarily and intended to have that result. In other words, drinking to forget. Drinking to forget can limit the ability to form some mens reas (state of mind), but leaves a wide variety of lesser charges that the person can face.

If you're going for realistic, it's hard to find a drug that's going to meet your requirements to present a defense in a courtroom. More likely, the government is going to want to deny that such a drug existed, and never bring the case.

Best of luck,

Jim Clark-Dawe

The good ol' MKUltra Sidney Gottleib/Frank Olsen scenario is a good one. The official story is that Olsen's suicide was a very unfortunate side-effect of a well-meaning CIA program. There are those who suggest more sinister motives (as if dosing some friendly bio-warfare experts with LSD wasn't sinister).

I know it is a cop out to reference a work of fiction, but Stanislaw Lem's The Chain of Chance worked some similar ground in regards to accidental intoxication with psychoactive substances. Of course Lem was a lot more interested in randomness coalescing into patterns than any chemical specifics.

EDIT: Seconding the mentions of risks of psychiatric meds. Especially when mixing meds, or having dosages increased or decreased. Doctors can screw up and patients don't always report what they are taking. I knew a person who ended up the victim of potentially lethal violence from someone close to them who had her meds jim-jammed by a doc.

Lil said:

LSD

It was tested by the CIA on unsuspecting people, and there were reports of all sorts of bizarre reactions, including psychosis, years afterward.

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Wouldn't that be a psychotic break(a form of schizophrenia) rather than the actual form of antisocial personality disorder known as psychosis?

Jimayo said:

Wouldn't that be a psychotic break(a form of schizophrenia) rather than the actual form of antisocial personality disorder known as psychosis?

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Do you mean antisocial personality disorder as in "psychopat"? Because that has nothing to do with psychosis or being psychotic.

Psychopathic - not the same as psychotic.

And a psychotic break is a psychotic break and doesn't need to have anything to do with schizophrenia.

Psychotic - not the same as schizophrenic.

Archerbird said:

Do you mean antisocial personality disorder as in "psychopat"? Because that has nothing to do with psychosis or being psychotic.

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True, but

And a psychotic break is a psychotic break and doesn't need to have anything to do with schizophrenia.

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Primary psychiatric causes of psychosis include the following:[5][6][7]

• schizophrenia and schizophreniform disorder

Psychosis is a general term for "gone completely bonkers" or, more technically, losing touch with reality. Psychosis is a symptom rather than a condition in itself (usually). Someone who's psychotic may be hallucinating or delusional but it's more than that - they're completely out of touch with reality. It's not like being high on drugs - it involves bizarre behaviours as well, which is where the danger lies. And a complete logical disconnect.

It's like the part in Firefly where River randomly slashes someone across the chest with a giant kitchen knife because "red suits him better". We're talking that level of complete disconnect with reality and right/wrong. We're past "I killed him because he's a spy for the CIA" and into "I was trying to kill the hand on his back. That's how the fairies are going to get out and eat us! He's a fairy now."

Recreational drugs probably won't cause this level of psychosis, but people who use meth a lot get amphetamine psychosis because longterm use of the drug screws up the dopamine pathways in their brain. (They also end up with holes in their brain!)

Psychosis is a symptom of schizophrenia but there's more to the disease than that (paranoid delusions usually feature heavily).

To get crudely technical, too much dopamine in the brain = psychosis. So an excess of dopamine, or substances that act like dopamine, or over-sensitive dopamine receptors, or drugs that stimulate dopamine receptors, can all cause psychosis. And Parkinson's disease is caused (probably - we think) by a lack of dopamine in the brain, so it's treated with dopamine precursors... which can lead to too much dopamine and hence psychosis.

This is all a bit over-simplified but you get the idea.

Similarly antipsychotic drugs can give people Parkinson's-like symptoms like shaking. /brain geekery>

Frankly, I would go with anti-depressants. They affect the frontal lobe directly. That's the area that handles a majority of our emotional responses and cognative thinking. Block that out and -Bam- Instant psychosis. Since they try to make them as organic as possible, it could be possible that they use chemicals naturally found in the brain. The kind in which the effects fade away as the chemicals run their course.

Something else, a frequent symptom of drug withdrawl is hallucinations and psychotic symtoms.

zombie thread alert!

Lil said:

LSD

It was tested by the CIA on unsuspecting people, and there were reports of all sorts of bizarre reactions, including psychosis, years afterward.

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It was self-tested by many more. With similar results...

Seriously though, drug trials just don't go that far awry. At least not at the present time, or in the US. Add in a secondary condition that can be part of the cause, like it's her third trial and the drugs are interacting and she never told anyone about previous trials. Or that she was a prior LSD user...

Jeff

Psilocybin, the active ingredient in hallucinogenic mushrooms, shuts down parts of the brain that are responsible for regulating a sense of self.
In controlled settings, the drug may be a useful therapeutic tool for treating depression, anxiety and other psychiatric problems.
In the study, the rush of the first 10 to 30 seconds induced some fear, he added, but positive feelings then immediately swept over them.

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Source: http://news.discovery.com/human/magic-mushrooms-depression-122301.html

As jclarkdawe points out, drug induced psychosis probably wouldn't be a complete defense to something like murder (and in the UK, it is definitely not a defense). But it can be a factor in reducing a charge from murder to voluntary or (maybe) involuntary manslaughter. I don't know if the UK allows the prosecution to present a range of charges to the jury, but if they could and if they did, then you could bring out things about the drug on that basis.

But aside from the trial, in the UK drug induced psychosis can be a factor at sentencing. So maybe you could start with the sentencing rather than the trial.

take care

---Jones()