"Madhouse" was released as the only single and third track from the group's second full album, Spreading the Disease.

The song is written in an up-tempo time signature, with heavy distorted guitar riffs.

[2] It has become a staple of live concerts, and has also appeared on Anthrax's "best of" album, Anthrology: No Hit Wonders (1985–1991).

The 12" vinyl features a cover version of the Sex Pistols song "God Save the Queen".

A music video was produced, which features the band performing in an insane asylum with several mental patients moving along to the tune.