In 2000, writer Guinevere Turner and writer/director Mary Harron adapted American Psycho into a dark, comic film released by Lions Gate Films. This screenplay was selected over three others, including one by Ellis himself. Bateman is played by Christian Bale with Willem Dafoe and Reese Witherspoon in supporting roles. As a promotion for the film, one could register to receive e-mails "from" Patrick Bateman, supposedly to his therapist. The e-mails, written by a writer attached to the film and approved by Ellis, follow Bateman's life since the events of the film. American Psycho premiered at the 2000 Sundance Film Festival where it was touted as the next Fight Club. The Motion Picture Association of America (MPAA) gave the film an NC-17 rating for a scene featuring Bateman having a threesome with two prostitutes. The producers excised approximately 18 seconds of footage to obtain an R-rating for the film.
It polarized audiences and critics with some showering praise, others scorn. Upon its theatrical release, however, the film received positive reviews in crucial publications, including The New York Times which called it a "mean and lean horror comedy classic". Author Bret Easton Ellis said, "American Psycho was a book I didn't think needed to be turned into a movie," as "the medium of film demands answers," which would make the book "infinitely less interesting." The film currently holds a 67% "Fresh" rating on Rotten Tomatoes.
A direct-to-video spin-off, American Psycho 2 was released and directed by Morgan J. Freeman. This spin-off was not based on the novel or the original film, as its only connection with the original is the death of Patrick Bateman (played by Michael Kremko wearing a face mask), briefly shown in a flashback.
In 2009, Audible.com produced an audio version of American Psycho, narrated by Pablo Schreiber, as part of its Modern Vanguard line of audiobooks. A Hungarian version of the novel was written by Attila Hazai (1967-2012) called Budapesti skizo ("Budapest Psycho", 1997); it was Hazai's best known work but as of his death never translated into English.
In 2013, a Kickstarter campaign was launched by Ellis and others to get a musical stage adaptation made. The premiere of the musical, with music and lyrics by Duncan Sheik opened at the Almeida Theatre, London in December 2013. The role of Patrick Bateman was played by Matt Smith.
Also in 2013, FX was planning a TV series, set in the present, with Patrick Bateman in his 50s.