Thus, there was a high frequency of psychotic symptoms after intravenous cocaine use; patients with psychotic symptoms reported higher use of cannabis and benzodiazepines in the previous month and lower use of methadone. More tremors and stereotyped movements were observed in the group with psychotic symptoms. It is necessary to give a special approach to cocaine intravenous users.

Cite as: Corominas-Roso, M., Roncero, C., Eiroa-Orosa, F. J., Gonzalvo, B., Grau-Lopez, L., Ribases, M., … Casas, M. (2013). Brain-derived neurotrophic factor serum levels in cocaine-dependent patients during early abstinence. European Neuropsychopharmacology, 23(9) completed a two-week detoxification program at an inpatient facility. Two serum samples were collected for each patient at baseline and at the end of the protocol.Serum samples were also collected for 46 healthy controls (aged 35.52 ± 9.37 years).Demographic, consumption and clinical data were recorded for all patients.Significantly lower serum BDNF levels (p<.0001) were observed for cocaine-dependent patients at baseline compared to healthy controls. Serum BDNF levels increased significantly across 12 days of early abstinence (p = .030). Baseline BDNF levels correlated with craving (p = .034). Post-detoxification BDNF levels correlated with craving (p = .018), loss of control (p < .000), abstinence measures (p = 0.031), depression (p = 0.036), and anxiety (p = 0.036). Post-detoxification BDNF levels also had predictive value for the loss of control measure of craving. Chronic cocaine use is associated with decreased serum BDNF. A progressive increase in serum BDNF levels during early abstinence correlates with cocaine craving and abstinence symptoms and may reflect increasing BDNF levels in different brain regions. These findings suggest that serum BDNF may be a biomarker for cocaine addiction.

Cocaine consumption can induce transient psychotic symptoms, expressed as paranoia or hallucinations. Cocaine induced psychosis (CIP) is common but not developed in all cases. This is the first European study on the relationship between CIP, consumption pattern variables and personality disorders. We evaluated 173 cocaine-dependent patients over 18 years; mostly males, whose average age was 33.6 years (SD = 7.8). Patients attending an outpatient addictions department were enrolled in the study and subsequently systematically evaluated using SCID I and SCID II interviews for comorbid disorders, a clinical interview for psychotic symptoms and EuropASI for severity of addiction. A high proportion of cocaine dependent patients reported psychotic symptoms under the influence of cocaine (53.8%), the most frequently reported being paranoid beliefs and suspiciousness (43.9%). A logistic regression analysis was performed, finding that a model consisting of amount of cocaine consumption, presence of an antisocial personality disorder and cannabis dependence history had 66.2% sensitivity 75.8% specificity predicting the presence of CIP. In our conclusions, we discuss the relevance of evaluating CIP in all cocaine dependent-patients, and particularly in those fulfilling the clinical profile derived from our results. These findings could be useful for a clinical approach to the risks of psychotic states in cocaine-dependent patients.