GABAergic Psychoactive Substance-Induced Delirium: Narrative Literature Review

Abstract

Psychoactive substance-induced delirium is delirium which occurs during or immediate after psychoactive substance intoxication, withdrawal or during the use of specific psychoactive substance. It is characterized by sudden onset of disturbed consciousness, disorientation, hallucinations, changed psychomotor activity, insomnia, acute memory impairment, violent, and bizarre behaviour. The most commonly abused psychoactive substances which may induce delirium are those acting on the major inhibitory neurotransmitter gamma aminobutyric acid (alcohol, anxiolytics, sedatives, hypnotics, and gammahydroxybutyrate- GHB. Psychoactive substance-induced delirium may have hyperactive, hypoactive or mixed clinical presentation. Treatment of delirium induced by psychoactive substances is carried out with antipsychotics, anxiolytics, and sedatives, but each of the listed abused psychoactive substances has its own treatment peculiarities. This narrative literature review describes the epidemiology, pathophysiology, clinical presentation, and treatment of delirium induced by intoxication and withdrawal from GABAergic psychoactive substances. The paper summarizes well-known knowledge with the latest research in psychoactive substances-induced delirium.