Substance-Specific Treatment Responses and Resistance Patterns in Induced Psychoses: A Scoping Review of Antipsychotic Efficacy
Valerio Ricci, Stefania Chiappini, Giovanni Martinotti, Giuseppe Maina
Healthcare December 8, 2025 DOI: 10.3390/healthcare13243210 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Scoping review Randomized Case report Peer reviewed |
|---|---|
| Sample size | 17 |
| Population | Studies examining antipsychotic treatment in cannabis-, stimulant-, and hallucinogen-induced psychoses |
| Keywords | Quetiapine Risperidone Observational study Randomized controlled trial Cochrane library Lurasidone Haloperidol Medline Systematic review Evidence-based medicine Atypical antipsychotic Critical appraisal Pharmacology Olanzapine |
| Key findings | Evidence for antipsychotic treatment in substance-induced psychoses is scarce and uneven, with most studies covering cannabis- and methamphetamine-induced psychosis, and no controlled studies for cocaine- or hallucinogen-induced psychoses. |
Abstract
Objective: To scope the available literature on antipsychotic treatment in substance-induced psychotic disorders, summarize evidence across substance categories, and highlight priorities for future research.
Methods: This scoping review followed Arksey and O’Malley’s framework and PRISMA-ScR guidelines. A systematic search of PubMed, Scopus, Embase, PsycINFO, and Cochrane Library (January 1985–August 2025) identified studies examining antipsychotic treatment in cannabis-, stimulant-, and hallucinogen-induced psychoses. Two reviewers independently screened studies and extracted data using a standardized form. Given marked heterogeneity, findings were synthesized descriptively.
Results: Seventeen studies met inclusion criteria: 3 randomized controlled trials (17.6%), 10 observational studies (58.8%), and 4 case series (23.5%). Most evidence involved cannabis-induced (n = 7) and methamphetamine-induced (n = 6) psychosis. Randomized trials showed comparable efficacy between risperidone and haloperidol for cannabis-induced psychosis, and between quetiapine and haloperidol for methamphetamine-induced psychosis. Case series suggested potential benefits of third-generation antipsychotics such as lurasidone and cariprazine. No controlled studies were identified for cocaine- or hallucinogen-induced psychoses.
Conclusions: Evidence for antipsychotic treatment in substance-induced psychoses remains scarce and uneven. While conventional antipsychotics appear effective for cannabis- and methamphetamine-related presentations, other substances remain virtually unstudied. Substantial evidence gaps and limited methodological quality highlight urgent research needs.