Alcohol-Related Hallucinosis

Chronic alcohol use can result in an organic psychotic disorder, most commonly with hallucinatory features (alcohol-related hallucinosis), that can be difficult to differentiate from other causes of psychosis. Hallucinosis is uncommon and typically resolves with abstinence but may recur and may be associated with adverse outcomes.  

Unlike alcohol withdrawal delirium, the patient will have a clear sensorium during alcohol-related hallucinosis; but typically they will experience auditory (or less often visual) hallucinations  and persecutory delusions while they are drinking. Such hallucinations may persist during withdrawal and can be mistaken for alcohol withdrawal hallucinations. The risk of suicide has been highlighted in several reports. 

Treatment with antipsychotic medications is recommended if the symptoms are distressing until long-term abstinence is achieved and symptoms ameliorate. The prognosis in these patents is usually good if long-term abstinence is maintained, although some will develop a chronic schizophrenia-like syndrome.