Pharmacotherapy in Psychiatry and Neurology
eISSN: 2449-9315
ISSN: 1234-8279
Pharmacotherapy in Psychiatry and Neurology/Farmakoterapia w Psychiatrii i Neurologii
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1/2025
vol. 41
 
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abstract:
Case report

Psychoactive substances as a catalyst for schizophrenia – a case report

Rafał Bieś
1
,
Monika Kalicka
2
,
Ewa Martyniak
3
,
Marek Krzystanek
3

  1. Doctoral School, Department and Clinic of Psychiatric Rehabilitation, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
  2. Student Scientific Association, Department and Clinic of Psychiatric Rehabilitation, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
  3. Clinic of Psychiatric Rehabilitation, Department of Psychiatry and Psychotherapy, Medical University of Silesia in Katowice, Katowice, Poland
Farmakoterapia w Psychiatrii i Neurologii 2025, 41 (1), 57-63
DOI: https://doi.org/10.5114/fpn.2025.154615
Online publish date: 2025/10/30
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Objectives
The use of psychoactive substances, including marijuana and MDMA, can trigger or exacerbate psychotic disorders, particularly in individuals predisposed to schizophrenia.

Case report
This report presents the case of a 24-year-old man who experienced his first psychotic episode after regular marijuana use and a single ingestion of MDMA. His symptoms included referential delusions, auditory hallucinations, and depersonalisation. Subsequent substance use led to relapses, necessitating multiple hospitalisations and treatment with clozapine.

Conclusions
This case underscores the risks associated with psychoactive substance use in individuals predisposed to psychotic disorders and highlights the importance of long-term monitoring for patients with dual diagnoses. The report also illustrates the distinct clinical presentation in schizophrenia patients who use psychoactive substances, emphasising the importance of careful consideration in the context of emerging psychedelic therapies in psychiatry.

keywords:

schizophrenia, psychosis, psychoactive substances, marijuana, MDMA

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