EPA-1011 - A Case Series of Codeine Cough Syrup Induced Psychotic Illness in a National Addictions Management Service

Abstract

Introduction:

Codeine Induced Psychotic Disorder is a poorly characterized illness but is increasingly being reported amongst cough mixture abusers. A study done in Hong Kong found that substance induced psychotic disorder is the most common psychiatric diagnosis amongst cough mixture abusers.

Objectives/Aims:

We aim to describe the clinical characteristics of patients referred to our National Addictions Management Service with a diagnosis of Substance Induced Psychotic Disorder secondary to Codeine cough syrup use.

Methods:

A retrospective audit of clinical records was done for patients seen at our National Addictions Management Service from Apr 2007 to Mar 2013 with a diagnosis of Substance Induced Psychotic Disorder secondary to codeine use. Patients with a prior primary psychotic disorder diagnosis were excluded from the study.

Results:

11 patients (9 male, 2 female) out of a total of 48 patients with substance induced psychotic disorder had used codeine cough syrup. 4 of the patients had concomitantly used other substances as well. The age range of the patients was 28-45 yrs with a mean of 37.3 yrs. The duration of hospitalization during their psychotic episode ranged from 4-38 days with a mean of 13.5 days. 10 out of 11 patients were started on antipsychotics at baseline. At the end of a one year follow up period, two patients had their diagnosis revised to that of schizophrenia.

Conclusions:

Codeine Induced Psychotic disorder is increasingly being seen amongst codeine abusers and more research is needed to better characterize this condition and determine the biological mechanisms behind it.