Psychosis & Relapse. Often times, medications need adjustments, even as an outpatient so the patient can get back on track. Smoking and tobacco use may reduce the levels in one's system of certain medications. A patient may have been stabilized on an anti- psychotic medication in the hospital and then after discharge and when the smoking starts back, the levels fall and the person may become more psychotic.
Yes. Though uncommon when stable, it can occur while on meds it can be random or due to stress.It occurs in formal thought disorders(schizophrenia) and psychotic bipolar disoders or psychotic depressions. Usually an increase in medication dosage is enough to correct it. Sometimes a change in medication is needed. Changing a med one has been on a long time isn't advised. Increase it.