Cocaine-Induced Psychotic Disorders: Presentation, Mechanism, and Management

Abstract

Cocaine, the third mostly commonly used illicit drug in the United States, has a wide range of neuropsychiatric effects, including transient psychotic symptoms. When psychotic symptoms occur within a month of cocaine intoxication or withdrawal, the diagnosis is cocaine-induced psychotic disorder (CIPD). Current evidence suggests those with CIPD are likely to be male, have longer severity and duration of cocaine use, use intravenous cocaine, and have a lower body mass index. Differentiating CIPD from a primary psychotic disorder requires a detailed history of psychotic symptoms in relation to substance use and often a longitudinal assessment. Treatment includes providing a safe environment, managing agitation and psychosis, and addressing the underlying substance use disorder. This review begins with a clinical case and summarizes the literature on CIPD, including clinical presentation, differential diagnosis, mechanism and predictors of illness, and treatment.

Adolescent but not adult ethanol binge drinking modulates cocaine withdrawal symptoms in mice

“…This is a cross-species translational model that allows some features of schizophrenia to be studied [27, 31–32]. Therefore, given that it has been demonstrated that cocaine withdrawal is often accompanied by psychotic symptoms [20], in the present experiment we evaluated the effect of our treatments on the PPI response. To this end, we used a PPI apparatus consisting of a Plexiglas tube (28 × 15 × 17 cm) with a platform containing a sensor on its base, so that if the animal moves, the force exerted on the platform is detected.…”

L‐type Ca2+ channels in mood, cognition and addiction: integrating human and rodent studies with a focus on behavioural endophenotypes

“…Conversely, patients with psychiatric disorders may have an increased vulnerability to abuse drugs. Patients with anxiety disorders, BD and SCZ have an increased likelihood of cocaine and stimulant use (Volkow, 2009;Post & Kalivas, 2013;Tang et al 2014).…”

“…Patients with anxiety disorders, BD and SCZ have an increased likelihood of cocaine and stimulant use (Volkow, ; Post & Kalivas, ; Tang et al . ).…”

Diagnóstico erróneo de psicosis inducida por cocaína en una persona con esquizofrenia y masticadora de hojas de coca.

“…El consumo de clorhidrato de cocaína, pasta básica de cocaína y base libre o crack, se ha asociado a la presentación, transitoria o persistente, de síntomas psicóticos (10). Durante la intoxicación cocaínica es muy frecuente la emergencia de vivencias paranoides y fenómenos pseudoperceptivos aunque, si el individuo consumidor puede ejercer crítica sobre estos fenómenos, no se los juzga como plenamente psicóticos (la aparición de estos fenómenos sí predice el desarrollo ulterior de episodios psicóticos de mayor duración) (11). La incidencia de psicosis en consumidores de estimulantes es variable, según se trate de individuos con uso recreacional de cocaína (18%), consumidores con problemas de dependencia y que buscan atención psiquiátrica (64-85%) o individuos que consumen cocaína en contextos experimentales (hasta 100%) (12).…”