An International Perspective and Review of Cocaine-Induced Psychosis: A Call to Action

Abstract

Cocaine use can induce transient psychotic symptoms that include suspiciousness, paranoia, hallucinations, and other cocaine-related behaviors. In this commentary, the authors provide an international perspective while reviewing the recent advances in epidemiology, clinical features, and risk factors related to cocaine-induced psychosis exhibited by patients with cocaine use disorders. In some settings, the occurrence of cocaine-induced psychosis has been shown to be as high as 86.5%. Many risk factors have been linked with cocaine-induced psychosis, including the quantity of cocaine consumed, lifetime amount of cocaine use, onset of cocaine dependence, years of use, routes of administration, other substance use disorder comorbidity, weight, gender, comorbidity with other medical and mental health disorders, genetics, and pharmacological interactions. Research has shown that the evaluation of cocaine-induced psychosis in patients with cocaine use is clinically relevant, especially in those patients who consume high amounts of cocaine, have a cannabis dependence history, have antisocial personality disorder, use administration routes other than intranasal, or exhibit attention-deficit/hyperactivity disorder (ADHD) comorbidity. Currently, the literature lacks information regarding the evolution of cocaine dependence or cocaine-dependent patients' risk for developing schizophrenia or other psychotic disorders. Furthermore, clinicians still do not have an evidence-based pharmacological approach to management of cocaine dependence available to them. Additional research is also needed regarding risk factors such as neurobiological markers and personality traits. Finally, we recommend the development of an integrative model including all of the risk factors and protective factors for cocaine-induced psychosis.

Psychiatric comorbidities in opioid-dependent patients undergoing a replacement therapy programme in Spain: The PROTEUS study

“…Psychotic disorders were more frequent in patients treated concomitantly for cocaine abuse, in agreement with previous studies showing an association between manic episodes and the use of CNS stimulants (Dalmau et al, 1999;Maremmani et al, 2012;Schuckit, 2006) and specifically between psychotic symptoms and the use of cocaine (Roncero et al, 2014a;Roncero et al, 2014b). Additionally, there were more men with psychotic disorders, while women suffered more frequently from sexual and gender identity disorders, consistent with previous studies in OD patients that showed an association between certain psychiatric disorders and gender.…”

Self-perceived quality of life in cocaine dependents with or without dual diagnosis

“…1,2 Patients with substance use disorders (SUD) and other comorbid mental disorders are called dual diagnosis or dual disorder patients (DD). These patients have little awareness of their disease.…”

La méthamphétamine – un stimulant comme les autres ou un problème plus complexe ?

“…La prise de MA est donc associée, pour plusieurs, à des problèmes de santé mentale graves persistant même après l'arrêt de la consommation. Ces prédicteurs ressemblent beaucoup aux pré-dicteurs de symptômes psychotiques transitoires retrouvés chez les utilisateurs de cocaïne (Roncero et al, 2014). Toutefois, les études portant sur la cocaïne ne semblent pas avoir examiné les prédicteurs de symptômes psychotiques persistants.…”