Neurologic Effects of Cocaine Clinical Presentation

Updated: Dec 15, 2015
  • Author: Pinky Agarwal, MD; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Acute effects 

Acute effects of cocaine use include the following:

  • Decreased food intake

  • Increased activity

  • Effusiveness

  • Diminished fatigue

Long-term use

Long-term use of cocaine interferes with sleep, can lower seizure threshold, and lead to palatal perforation. 

Overdose of cocaine

Signs of a cocaine overdose include the following:

  • Convulsions

  • Hyperthermia

  • Coma

Neuropsychiatric complications

Psychiatric disturbances include depression, suicidal ideation, paranoia, kleptomania, violent antisocial behavior, catatonia, and auditory or visual hallucinations. Cocaine use may lead to impulsivity, resulting in sexually risky behavior and increasing the risk of becoming infected with HIV.

Headache is a relatively frequent symptom (3.5%) in cocaine users. Headaches occur in 11% of cocaine paste smokers.


Convulsions occur in about 1-40% of cocaine users. [10] Convulsions caused by cocaine can be generalized or partial, simple or complex. The majority of seizures are single, generalized, induced by intravenous or crack cocaine, and not associated with any lasting neurological deficits. Most focal, multiple, or induced seizures caused by nasal insufflation of cocaine are associated with an acute intracerebral complication or concurrent use of other drugs.

All routes of administration are associated with seizures, and seizures can be induced in some persons by small quantities of cocaine. Once intoxication has passed, these individuals do not require long-term anticonvulsant therapy.

Although most cocaine-induced seizures are benign and self-limiting, seizures may be due to other more severe complications, such as infarction and intracranial hemorrhage.

Renal failure

Cocaine can cause acute renal failure resulting from rhabdomyolysis or vasospasm.



A dose-dependent increase in heart rate and blood pressure can occur.