eMedicine Specialties > Psychiatry > Addiction
Cocaine-Related Psychiatric Disorders: Treatment & Medication
Updated: May 28, 2008
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
Treatment
Medical Care
People who abuse cocaine present with many different medical symptoms. At times, clinicians may have difficulty determining which signs and symptoms are significant and which are not. For example, cocaine-induced chest pain is usually benign. However, these patients may have an acute coronary syndrome, pneumothorax, pulmonary embolism, pulmonary edema, or aortic dissection. Before these patients are discharged home or admitted to a psychiatric ward, the clinicians involved must evaluate the patient for other nonpsychiatric medical problems.
- Cocaine intoxication
- Acute cocaine intoxication is usually self limited and can be managed with supportive care.
- Benzodiazepines are the first-line therapy in treating patients who are intoxicated from cocaine and are extremely agitated. Typically, benzodiazepines can be titrated until the patient is calm and the pulse and blood pressure have stabilized.
- Use neuroleptics with caution in acute intoxication. Acute hyperthermia syndromes associated with acute cocaine intoxication have been reported, and the use of neuroleptics with the risk of neuroleptic malignant syndrome may confuse this situation.
- Specific laboratory tests can be ordered as necessary.
- Cocaine-induced chest pain
- Chest pain associated with cocaine use may be from musculoskeletal, cardiovascular, or pulmonary etiologies.
- Obtain a chest radiograph to exclude localized infiltrates, pneumothorax, pneumomediastinum, and pulmonary edema. An ECG and serial cardiac enzyme evaluation assist in excluding acute myocardial infarction and acute coronary syndromes.
- If an acute coronary syndrome is suggested, then oxygen, aspirin, benzodiazepines, and nitroglycerin can be administered. Nonselective beta-blockers are best avoided in all patients who are intoxicated with cocaine.
- Hypertension
- Cocaine-induced hypertension is treated first with benzodiazepines. Benzodiazepines decrease the cocaine-induced sympathomimetic drive from the CNS.
- If this fails, phentolamine may be considered. Phentolamine is an alpha-antagonist and counteracts cocaine's vasoconstrictive effects.
- Nitroprusside and nitroglycerin also may be considered.
- Seizures
- Cocaine-induced seizures may be either generalized or partial and result from cocaine toxicity itself or from a cocaine-induced process, such as a cerebral vascular accident.
- The first-line therapy is benzodiazepines, followed by barbiturates.
- Consider a head CT scan for seizures associated with the use of cocaine.
- No evidence exists that anticonvulsants prevent cocaine-induced seizures, and they are not recommended for this purpose.
- Rhabdomyolysis
- Rhabdomyolysis may manifest in patients who are agitated and intoxicated with cocaine. This disorder must be recognized early to prevent secondary renal failure.
- Obtain a creatine kinase measurement and test the urine for myoglobin. If the urinalysis reveals blood on the dipstick but no red blood cells upon microscopic examination, then myoglobinuria may be present.
- Treatment of rhabdomyolysis focuses on ensuring adequate urine output and, possibly, alkalization of the urine.
- Dyspnea
- Cocaine-induced dyspnea has multiple causes.
- Obtain a chest radiograph to exclude pulmonary edema, focal infiltrate, pneumothorax, and pneumomediastinum
- Psychiatric symptoms (see Further Inpatient Care)
Consultations
A number of consultations may be necessary when caring for a patient who abuses cocaine. Consultations to consider include medical toxicologists, regional poison control center personnel, cardiologists, neurologists, psychiatrists, substance abuse clinicians, and social services personnel, depending on the presenting signs and symptoms.
Medication
Cocaine induces 10 psychiatric disorders described in DSM-IV-TR. Treatment of each disorder varies. Benzodiazepines are the drugs of choice for acute cocaine intoxication with extreme agitation. Pharmacologic therapy depends on presenting signs and symptoms (eg, treat chest pain with oxygen, benzodiazepines, aspirin, and nitroglycerin). All possible pharmacotherapies for various cocaine-induced medical conditions are beyond the scope of this article. For a complete review of treating cocaine-induced nonpsychiatric effects, refer to Toxicity, Cocaine.
Avoid use of beta-blockers because of the unopposed alpha-agonist activity. The mood shifts, abnormal sleep and even delusions associated with acute cocaine intoxication or withdrawal often are transient and do not require medications. Persistent mood disorders with mania may be treated with lithium, whereas antidepressants are advocated for mood disorders with depressive features. Antipsychotics are advocated to treat persistent psychotic disorders.
Benzodiazepines
Bind specific benzodiazepine receptor on GABA-receptor complex, thereby increasing GABA affinity for its receptor. Increase the frequency of chlorine channel opening in response to GABA binding. GABA receptors are chlorine channels that mediate postsynaptic inhibition, resulting in postsynaptic neuron hyperpolarization. The final result is a sedative-hypnotic effect that counteracts the stimulant effect of cocaine.
Diazepam (Valium)
Depresses all levels of CNS (eg, limbic and reticular formation) possibly by increasing activity of GABA. Individualize dose and increase cautiously to avoid adverse effects.
Adult
2-10 mg PO/IV q3-4h, repeat q2-4h prn; not to exceed 30 mg/8 h; may give IM in similar doses, but absorption is erratic
Pediatric
0.05-0.3 mg/kg/dose over 2-3 min IV/IM, repeat in 2-4 h prn
0.12-0.8 mg/kg/d PO divided q6-8h; not to exceed 10 mg/dose
Coadministration of phenothiazines, barbiturates, alcohols, or MAOIs may increase CNS toxicity
Documented hypersensitivity; pregnancy; severe CNS or respiratory depression
Pregnancy
D - Fetal risk shown in humans; use only if benefits outweigh risk to fetus
Precautions
Caution with other CNS depressants, low albumin levels, or hepatic disease (may increase toxicity); prolonged use may cause dependance; do not discontinue abruptly following prolonged use
Lorazepam (Ativan)
Sedative hypnotic with short onset of effects and relatively long half-life. Increases action of GABA (ie, major inhibitory neurotransmitter in brain). May depress all levels of CNS, including limbic and reticular formation.
Adult
1-10 mg/d PO/IV/IM divided bid/tid
Pediatric
0.05 mg/kg/dose PO q4-8h; not to exceed 2 mg/dose
Toxicity of benzodiazepines in CNS increases when used concurrently with alcohol, phenothiazines, barbiturates, and MAOIs
Documented hypersensitivity; preexisting CNS depression; hypotension
Pregnancy
D - Fetal risk shown in humans; use only if benefits outweigh risk to fetus
Precautions
Caution in renal or hepatic impairment (adjust dose), myasthenia gravis, organic brain disease, dehydration, and Parkinson disease
Hepatic disease is less of a concern with lorazepam than many other benzodiazepines, such as diazepam (lorazepam is only glucuronated in the liver)
Prolonged use may cause dependance; do not discontinue abruptly following prolonged use
Midazolam (Versed)
Short-acting benzodiazepine used for acute or short-term sedation. Also exhibits amnestic effects.
Adult
Loading dose: 0.05-0.2 mg IV over 2 min
Maintenance dose: Infuse 1-2 mcg/kg/min IV titrated to desired effect
Dosing range: 0.4-6 mcg/kg/min IV
Alternatively: 0.07-0.08 mg/kg IM
Pediatric
Sedation, anxiolysis, or amnesia
<2 years: 1-2 mg intranasally, limited by volume delivered
>2 years: 0.1-0.15 mg/kg IV over 2-3 min; as much as 0.5 mg/kg may be needed for severe anxiety
Sedative effects may be antagonized by theophylline; coadministration with other CNS depressants increases sedation and respiratory depression; erythromycin may enhance sedative effects as a result of decreased clearance
Documented hypersensitivity; preexisting hypotension; sensitivity to propylene glycol (the diluent)
Pregnancy
D - Fetal risk shown in humans; use only if benefits outweigh risk to fetus
Precautions
Caution in congestive heart failure, pulmonary disease, renal impairment, and hepatic failure; prolonged use may cause dependance; do not discontinue abruptly following prolonged use
Antipsychotic agents
High-potency antipsychotic agents in the butyrophenone class (eg, haloperidol, droperidol) are used for rapid sedation. Easily titrated and cause less sedation and orthostasis; however, they cause extrapyramidal symptoms more often than lower-potency agents. Used short term to rapidly control psychosis.
Newer antipsychotics (eg, risperidone, olanzapine, quetiapine) are used for long-term management. Improvements over earlier antipsychotics include fewer anticholinergic effects and less dystonia, parkinsonism, and tardive dyskinesia. Affect dopamine and serotonin receptors.
Haloperidol (Haldol)
DOC for acute psychosis. Parenteral dosage form may be admixed in same syringe with 2 mg lorazepam for better anxiolytic effects.
Adult
0.5-5 mg PO bid/tid; may titrate prn to 30 mg/d; some patients require 100 mg/d
2-5 mg IM (as lactate) q4-8h prn
Pediatric
<3 years: Not established
3-12 years: 0.25-0.5 mg/d PO bid/tid initially, increase by 0.25-0.5 mg q5-7d; not to exceed 0.15 mg/kg/d
Maintenance dose: 0.05-0.15 mg/kg/d PO divided bid/tid; not to exceed 0.15 mg/kg/d
>12 years: Administer as in adults
May increase TCA serum concentrations and hypotensive action of antihypertensive agents; phenobarbital or carbamazepine may decrease effects; coadministration with anticholinergics may increase intraocular pressure; encephalopathylike syndrome associated with coadministration of lithium
Documented hypersensitivity; bone marrow suppression; severe cardiac disease; severe hypotension; liver disease; subcortical brain damage
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Severe neurotoxicity manifesting as rigidity or inability to walk or talk may occur in patients with thyrotoxicosis also receiving antipsychotics; monitor BP with parenteral administration; caution in CNS depression or cardiac disease; with history of seizures, benefits must outweigh risks; may cause neuroleptic malignant syndrome, restlessness, anxiety, extrapyramidal symptoms, dystonia, tardive dyskinesia, or Parkinsonlike syndrome
Droperidol (Inapsine)
DOC for severely disturbed and/or violent patient. Faster acting and more sedating than haloperidol but more likely to cause hypotension. May exert antipsychotic activity through dopaminergic system. Evidence suggests it alters dopamine action in CNS.
Adult
1.25-2.5 mg IV/IM as single dose
Pediatric
<2 years: Not established
2-12 years: 1-1.5 mg/9-11 kg/dose (20-25 lb) IV/IM as single dose
>12 years: Administer as in adults
May increase toxicity of CNS depressants
Documented hypersensitivity
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Monitor BP if hypovolemic or administered parenterally; may decrease pulmonary arterial pressure; high incidence of tardive dyskinesia (ie, 40%); elderly patients more vulnerable to extrapyramidal symptoms; may cause life-threatening arrhythmias
Risperidone (Risperdal)
Binds to dopamine D2-receptor with 20-times lower affinity than for 5-HT2-receptor. Improves negative symptoms of psychoses and reduces prevalence of adverse extrapyramidal effects.
Adult
1 mg PO bid initially, slowly increase to optimum range of 4-8 mg/d; not to exceed 10 mg/d
Pediatric
Not established
Carbamazepine may decrease serum levels; may inhibit effects of levodopa; clozapine may increase levels
Documented hypersensitivity
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
May cause extrapyramidal symptoms (especially > 6 mg/d), hypotension/orthostasis, tachycardia, arrhythmias, amenorrhea, galactorrhea, sexual dysfunction, GI toxicity, and cholestatic jaundice
Olanzapine (Zyprexa)
May inhibit serotonin, muscarinic, and dopamine effects.
Adult
5-10 mg PO qd, increase to 10 mg qd within 5-7 d, adjust by 5 mg/d at 1-wk interval; not to exceed 20 mg/d
Pediatric
Not established
CYP1A2 inhibitors (eg, fluvoxamine) may increase effects; antihypertensives may increase risk of hypotension and orthostatic hypotension; CYP inducers (eg, levodopa, pergolide, bromocriptine, charcoal, carbamazepine, omeprazole, rifampin, cigarette smoking) may decrease effects
Documented hypersensitivity
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Caution in narrow-angle glaucoma, cardiovascular disease, obesity, diabetes, lipidemias, prostatic hypertrophy, seizure disorders, hypovolemia, dehydration
Quetiapine (Seroquel)
May act by antagonizing dopamine and serotonin effects.
Adult
Initial: 25 mg bid/tid PO, increase by day 4 to 300-400 mg/d divided bid/tid; not to exceed 750 mg/d
Maintenance: 150-750 mg/d PO
Pediatric
Not established
May antagonize levodopa and dopamine agonists; CYP3A4 inducers (eg, phenytoin, thioridazine) may reduce levels; CYP3A4 inhibitors (eg, itraconazole, erythromycin) may increase levels; may decrease warfarin clearance, monitor aPTT
Documented hypersensitivity
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
May induce orthostatic hypotension associated with dizziness, tachycardia, and syncope; neuroleptic malignant syndrome has been reported; caution with seizures, cerebrovascular disease, and hepatic dysfunction (adjust dose); common adverse effects include somnolence, agitation, headache, and dizziness
Antidepressants
While numerous antidepressants are currently available, selective serotonin reuptake inhibitors (SSRIs) provide many advantages over past antidepressants. MAOIs should be avoided in mood disorders with depressive features. MAOIs are lethal if patient relapses from abstinence and combines them with cocaine.
Citalopram (Celexa)
Enhances serotonin activity by selective reuptake inhibition at the neuronal membrane.
Adult
20-60 mg PO qd; 10 mg/d initially, titrate by 10 mg/wk
Pediatric
Not established
Serotonin syndrome (ie, myoclonus, rigidity, confusion, nausea, hyperthermia, autonomic instability, coma, eventual death) may occur with simultaneous use of other serotonergic agents (eg, anorectic agents, tramadol, buspirone, trazodone, clomipramine, nefazodone, tryptophan), discontinue other serotonergic agents at least 2 wk prior to administering SSRIs; may be potentiated by azole antifungals, omeprazole, and macrolides
Despite this precaution, trazodone, nefazodone, and, to a lesser extent, buspirone, are commonly prescribed with SSRIs with very few scattered case reports of serotonergic syndrome
Has been speculated that the low prevalence of serotonergic syndrome with these medications in combination with SSRIs is due to postsynaptic serotonin receptor–blocking activity
Documented hypersensitivity; administration within 2 wk of MAOIs
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Caution in cirrhosis (adjust dose), suicidal tendencies, SIADH, DM, and breastfeeding; common adverse effects include fatigue, GI toxicity, and sexual dysfunction; symptoms of weakness, lethargy, headache, anorexia, weight gain, confusion, or constipation may indicate hyponatremia
Fluoxetine (Prozac)
Selectively inhibits presynaptic serotonin reuptake with minimal or no effect on reuptake of norepinephrine or dopamine.
Adult
20 mg/d PO qam, increase after several wk by 20 mg/d; not to exceed 80 mg/d
Pediatric
<18 years: Not established; initial doses of 20 mg/d in children 6-14 y have been used
Inhibits CYP3A4 and CYP2D6, therefore increases toxicity of isoenzyme substrates (eg, diazepam, trazodone, TCAs) by decreasing clearance; increases toxicity of MAOIs; may displace highly protein–bound drugs (eg, warfarin); serotonin syndrome (ie, myoclonus, rigidity, confusion, nausea, hyperthermia, autonomic instability, coma, eventual death) may occur with simultaneous use of other serotonergic agents (eg, anorectic agents, tramadol, buspirone, trazodone, clomipramine, nefazodone, tryptophan), discontinue other serotonergic agents at least 2 wk prior to administering SSRIs
Despite this precaution, trazodone, nefazodone, and, to a lesser extent, buspirone, are commonly prescribed with SSRIs with very few scattered case reports of serotonergic syndrome
Has been speculated that the low prevalence of serotonergic syndrome with these medications in combination with SSRIs is due to their postsynaptic serotonin receptor–blocking activity
Documented hypersensitivity; administration within 2 wk of MAOIs
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Caution in hepatic impairment (adjust dose) and history of seizures; common adverse effects include headache, somnolence, nervousness, dizziness, nausea, diarrhea, xerostomia, general weakness, and sexual dysfunction; symptoms of weakness, lethargy, headache, anorexia, weight gain, confusion, or constipation may indicate hyponatremia
Fluvoxamine (Luvox)
Inhibits neuronal serotonin reuptake. Does not significantly bind to alpha-adrenergic, histamine, or cholinergic receptors, thus has fewer adverse effects than TCAs.
Adult
50 mg PO hs initially, titrate by 50 mg/d q4-7d, divide total daily dose into 2 doses once maximum therapeutic benefit achieved; if doses are unequal, administer larger dose hs; not to exceed 300 mg/d
Pediatric
<8 years: Not established
8-18 years: 25 mg PO hs initially, titrate by 25 mg/d q4-7d; divide doses >50 mg/d into 2 doses; if doses are unequal, administer larger dose hs; not to exceed 200 mg/d
Coadministration with MAOIs increases risk of hypertensive crisis; inhibits CYP1A2, 2C9, 2C19, 2D6, and 3A4 and may potentiate effects of isoenzyme substrates (monitor plasma levels and adjust dose accordingly, consider alternative SSRI); alcohol, cimetidine, sertraline, phenothiazines, and warfarin increase toxicity; serotonin syndrome (ie, myoclonus, rigidity, confusion, nausea, hyperthermia, autonomic instability, coma, eventual death) may occur with simultaneous use of other serotonergic agents (eg, anorectic agents, tramadol, buspirone, trazodone, clomipramine, nefazodone, tryptophan), discontinue other serotonergic agents at least 2 wk prior to administering SSRIs
Despite this precaution, trazodone, nefazodone, and, to a lesser extent, buspirone, are commonly prescribed with SSRIs with very few scattered case reports of serotonergic syndrome
Has been speculated that the low prevalence of serotonergic syndrome with these medications in combination with SSRIs is due to postsynaptic
serotonin receptor–blocking activity
Documented hypersensitivity; administration within 2 wk of MAOIs
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Caution in liver dysfunction (adjust dose), cardiovascular disease, history of seizures, or suicidal tendencies; common adverse effects include headache, somnolence, nervousness, dizziness, nausea, diarrhea, xerostomia, general weakness, and sexual dysfunction; symptoms of weakness, lethargy, headache, anorexia, weight gain, confusion, or constipation may indicate hyponatremia
Paroxetine (Paxil)
Alternative DOC. Potent selective inhibitor of neuronal serotonin reuptake. Weak effect on norepinephrine and dopamine neuronal reuptake.
Adult
10 mg/d PO initially, increase by 10 mg/d prn qwk; usual dose range is 10-60 mg/d; not to exceed 60 mg/d
Pediatric
<18 years: Not established
>18 years: Administer as in adults
Phenobarbital and phenytoin decrease effects; alcohol, cimetidine, sertraline, phenothiazines, and warfarin increase toxicity; weak inhibitor of CYP 2D6, 1A2, and 3A4; serotonin syndrome (ie, myoclonus, rigidity, confusion, nausea, hyperthermia, autonomic instability, coma, eventual death) may occur with simultaneous use of other serotonergic agents (eg, anorectic agents, tramadol, buspirone, trazodone, clomipramine, nefazodone, tryptophan), discontinue other serotonergic agents at least 2 wk prior to administering SSRIs
Despite this precaution, trazodone, nefazodone, and, to a lesser extent, buspirone, are commonly prescribed with SSRIs with very few scattered case reports of serotonergic syndrome
Has been speculated that the low prevalence of serotonergic syndrome with these medications in combination with SSRIs is due to their postsynaptic serotonin receptor–blocking activity
Documented hypersensitivity; administration within 2 wk of MAOIs
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Caution in history of seizures, mania, renal or hepatic disease (adjust dose), and cardiac disease; common adverse effects include headache, somnolence, nervousness, dizziness, nausea, diarrhea, xerostomia, general weakness, and sexual dysfunction; symptoms of weakness, lethargy, headache, anorexia, weight gain, confusion, or constipation may indicate hyponatremia
Sertraline (Zoloft)
Selectively inhibits presynaptic serotonin reuptake.
Adult
50 mg/d PO qam, increase by 50 mg/d q2-3d to 100 mg/d, if tolerated; not to exceed 200 mg/d
Pediatric
<6 years: Not established
6-12 years: 25 mg PO qd
13-18 years: 50 mg PO qd
Doses in clinical trials ranged from 25-200 mg/d; adjust dose gradually, taking into consideration lower body weight
Coadministration with MAOIs increases risk of hypertensive crisis; inhibits CYP2C9, 2D6, 2C19, and 3A4; may displace highly protein–bound drugs (ie, warfarin); serotonin syndrome (ie, myoclonus, rigidity, confusion, nausea, hyperthermia, autonomic instability, coma, eventual death) may occur with simultaneous use of other serotonergic agents (eg, anorectic agents, tramadol, buspirone, trazodone, clomipramine, nefazodone, tryptophan), discontinue other serotonergic agents at least 2 wk prior to SSRIs
Despite this precaution, trazodone, nefazodone, and, to a lesser extent buspirone, are commonly prescribed with SSRIs with very few scattered case reports of serotonergic syndrome
Has been speculated that the low prevalence of serotonergic syndrome with these medications in combination with SSRIs is due to their postsynaptic serotonin receptor–blocking activity
Documented hypersensitivity
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Caution in seizure disorders, recent MI, unstable heart disease, hepatic dysfunction (adjust dose), or renal impairment; common adverse effects include headache, somnolence, nervousness, dizziness, nausea, diarrhea, xerostomia, general weakness, and sexual dysfunction; symptoms of weakness, lethargy, headache, anorexia, weight gain, confusion, or constipation may indicate hyponatremia
Venlafaxine (Effexor)
Inhibits neuronal serotonin and norepinephrine reuptake. Also causes beta-receptor down-regulation.
Adult
IR: 75 mg/d PO divided bid/tid with food; may titrate by 75 mg/d q4d to 225-375 mg/d
ER: 75 mg PO qd with food; may titrate by 75 mg/d q4d to 225 mg/d
Pediatric
Not established
Cimetidine, MAOIs, sertraline, fluoxetine, class IC antiarrhythmics, TCAs, and phenothiazine may increase effects; CYP2D6 substrate; serotonin syndrome (ie, myoclonus, rigidity, confusion, nausea, hyperthermia, autonomic instability, coma, eventual death) may occur with simultaneous use of other serotonergic agents (eg, anorectic agents, tramadol, buspirone, trazodone, clomipramine, nefazodone, tryptophan), discontinue other serotonergic agents at least 2 wk prior to SSRIs
Documented hypersensitivity; administration within 2 wk of MAOIs
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Coadministration or use within 2 wk of MAOIs may cause hypertensive crisis; caution in cardiovascular disorders, renal or hepatic dysfunction (adjust dose), seizure disorder, suicidal tendency, or mania; common adverse effects include headache, somnolence, nervousness, dizziness, nausea, diarrhea, xerostomia, general weakness, and sexual dysfunction; symptoms of weakness, lethargy, headache, anorexia, weight gain, confusion, or constipation may indicate hyponatremia
More on Cocaine-Related Psychiatric Disorders |
| Overview: Cocaine-Related Psychiatric Disorders |
| Differential Diagnoses & Workup: Cocaine-Related Psychiatric Disorders |
 Treatment & Medication: Cocaine-Related Psychiatric Disorders |
| Follow-up: Cocaine-Related Psychiatric Disorders |
| References |
| « Previous Page | Next Page » |
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Further Reading
Keywords
cocaine, coke, crack, psychosis, delirium, anxiety, withdrawal, Erythroxylon coca, E coca, coca leaf, coca plant, cocaine addiction, cocaine abuse, drug abuse, drug addiction, addiction, drugs, drug-related psychosis, drug-related psychiatric disorder, cocaine intoxication, cocaine withdrawal, cocaine delirium, cocaine-induced psychotic disorder with delusions, cocaine-induced psychotic disorder with hallucinations, cocaine-induced mood disorder, cocaine-induced anxiety disorder, cocaine-induced sexual dysfunction, cocaine-induced sleep disorder
