even after postpartum. Medical conditions A very large number of medical conditions can cause psychosis, sometimes called secondary psychosis. Examples include: disorders causing delirium (toxic psychosis), in which consciousness is disturbed neurodevelopmental disorders and chromosomal abnormalities, including velocardiofacial syndrome neurodegenerative disorders, such as Alzheimer's disease, dementia with Lewy bodies, and Parkinson's disease focal neurological disease, such as stroke, brain tumors, multiple sclerosis, and some forms of epilepsy malignancy (typically via masses in the brain, paraneoplastic syndromes) infectious and postinfectious syndromes, including infections causing delirium, viral encephalitis, HIV/AIDS, malaria, syphilis endocrine disease, such as hypothyroidism, hyperthyroidism, Cushing's syndrome, hypoparathyroidism and hyperparathyroidism; sex hormones also affect psychotic symptoms and sometimes giving birth can provoke psychosis, termed postpartum psychosis inborn errors of metabolism, such as Wilson's disease, porphyria, and homocysteinemia. nutritional deficiency, such as vitamin B12 deficiency other acquired metabolic disorders, including electrolyte disturbances such as hypocalcemia, hypernatremia, hyponatremia, hypokalemia, hypomagnesemia, hypermagnesemia, hypercalcemia, and hypophosphatemia, but also hypoglycemia, hypoxia, and failure of the liver or kidneys autoimmune and related disorders, such as systemic lupus erythematosus (lupus, SLE), sarcoidosis, Hashimoto's encephalopathy, anti-NMDA-receptor encephalitis, and non-celiac gluten sensitivity poisoning, by therapeutic drugs (see below), recreational drugs (see below), and a range of plants, fungi, metals, organic compounds, and a few animal toxins sleep disorders, such as in narcolepsy (in which REM sleep intrudes into wakefulness) parasitic diseases, such as neurocysticercosis huntington disease Psychoactive drugs Various psychoactive substances (both legal and illegal) have been implicated in causing, exacerbating, or precipitating psychotic states or disorders in users, with varying levels of evidence. This may be upon intoxication for a more prolonged period after use, or upon withdrawal. Individuals who experience substance-induced psychosis tend to have a greater awareness of their psychosis and tend to have higher levels of suicidal thinking compared to those who have a primary psychotic illness. Drugs commonly alleged to induce psychotic symptoms include alcohol, cannabis, cocaine, amphetamines, cathinones, psychedelic drugs (such as LSD and psilocybin), κ-opioid receptor agonists (such as enadoline and salvinorin A) and NMDA receptor antagonists (such as phencyclidine and ketamine). Caffeine may worsen symptoms in those with schizophrenia and cause psychosis at very high doses in people without the condition. Cannabis and other illicit recreational drugs are often associated with psychosis in adolescents and cannabis use before 15 years old may increase the risk of psychosis in adulthood. Alcohol Approximately three percent of people with alcoholism experience psychosis during acute