Overview
Drug-induced delusional disorder is a condition where delusions are caused by the physiological effects of a substance or medication. These delusions can be a prominent feature of intoxication or withdrawal from various drugs of abuse or prescribed medications.Diagnosis
Diagnosis requires the presence of delusions and evidence that they are the direct physiological consequence of a substance or medication 12.
The disturbance is not better explained by another mental disorder 12.
The disturbance does not occur exclusively during the course of delirium 12.
The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning 12.Management
The primary management strategy involves discontinuing the offending substance or medication 12.
Supportive care and monitoring for withdrawal symptoms are essential 12.
Antipsychotic medications may be considered for severe symptoms, but their use should be guided by the specific substance and clinical presentation 12.
Clozapine is associated with significantly more somnolence compared to other antipsychotics 1.
Patients treated with other antipsychotics versus clozapine have a significantly increased odds of insomnia 2.Special Populations
Age may be a factor in the association with insomnia when comparing clozapine to other antipsychotics 2.Key Recommendations
Discontinuation of the offending substance or medication is the cornerstone of management for drug-induced delusional disorder 12. (Evidence: Strong)
Clozapine is associated with a significantly increased odds of somnolence compared to other antipsychotics 1. (Evidence: Strong)
Other antipsychotics are associated with a significantly increased odds of insomnia compared to clozapine 2. (Evidence: Strong)References
1 Hopkins MR, Miller BJ. Meta-analysis of clozapine and somnolence in schizophrenia. Journal of psychopharmacology (Oxford, England) 2025. link
2 Miller BJ, McEvoy JP, McCall WV. Meta-analysis of clozapine and insomnia in schizophrenia. Schizophrenia research 2023. link