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Can Opioids Attenuate some of the symptoms of Psychosis? I ask because there's a dead link on the Wikipedia page that's meant to support the notion that opioids attenuate some of the symptoms of mental illness including those of psychosis (i.e. opioids exhibit antipsychotic effects) and I felt it was an interesting question.

Please quote Journal Articles with links to said articles.

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Both the causes and symptoms of psychoses are very complex. I think it is essential to narrow this question down, or at least specify a) what kind of psychosis (schizophrenic, drug-induced (e.g. illicit drugs or prescription-based) and b) what symptoms, most notably there are positive and negative symptoms. If you are targeting any symptom I think this question becomes too broad. c) Another issue is self-medication; many, many schizophrenics self-medicate and taking opiates may simply be a portal to a peaceful world relieving the patient of the distressing psychotic symptoms. – Christiaan Jun 10 at 11:20
They're not used for this purpose in clinical practice at least – Rory M Jun 10 at 11:48

1 Answer 1

9 Substance-Induced Disorders says...

Withdrawal results in agitation, severe body aches, gastrointestinal symptoms, dysphoria, and craving to use more opioids. Symptoms during withdrawal vary—some will become acutely anxious and agitated, while others will experience depression and anhedonia.

It adds that even with complete abstinence that these symptoms can last for weeks.

The paper sites Levinson et al. 1995 and Zukin and Zukin (1992) under the Opioid section, and also talks about PCP and it's effects such as an acute psychotic state.

PCP may have been included there as states:

PCP is a noncompetitive NMDA/glutamate receptor antagonist, but also interacts with other receptor sites, and may have effects with dopamine, opioid and nicotinic receptors.

Opioids and the Treatment of Chronic Pain: Controversies, Current Status, and Future Directions also explores opioid usage. They say that there are some people on opioids who have problematic behaviour that isn't related to the drugs. They do say that people who actually need the opioids act differently than people who are abusing the opioids, but it's not mutually exclusive. "[...] some patients who are treated for pain do develop severe behavioral disturbances indicative of a comorbid addictive disorder."

  • Levinson I, Galynker II, Rosenthal RN. Methadone withdrawal psychosis. Journal of Clinical Psychiatry. 1995;56:73–76. PubMed
  • Zukin, S.R., and Zukin, R.S. Phencyclidine. In: Lowinson, J.H., Ruiz, P., Millman, R.B., and Langrod, J.G., eds. Substance Abuse: A Comprehensive Textbook. Baltimore: Williams & Wilkins, 1992. pp. 290–302.

Continued research suggests that the only psychological effect that opioids have are psychological addiction. Although it can act as a sedative according to Benyamin et al. (but it is listed as a side effect).

In this study, they concluded that long-term use actually reduced functional connectivity in the brain. Although the patients that they were compared against had to be of clear health physically and mentally.

I was unable to find anything that suggested that it would help with psychosis. Most data suggests that it should only be used on a short term basis and long term use actually can cause detrimental effects mentally and physical dependance.

According to withdraw actually causes psychosis and other detrimental effects, most of the research has been focused on getting away from opioids. It would probably be a bad idea to treat psychosis with a drug whose withdraw symptoms include psychosis.

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Although this is a nicely literature-supported answer, I think it does not target the question whether opioids alleviate psychosis. – Christiaan Jun 10 at 11:24
I've added some research @AliceD – SolarLunix Jun 10 at 14:08

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