Causes and Risks:

Cocaine exerts its euphoric effect by maintaining high levels of neurotransmitters in the brain that are responsible for the feelings of reward and satisfaction. (Neurotransmitters are responsible for carrying a specific signal from one brain cell to a "receptor" on an adjoining brain cell.) Studies suggest that the brain, in response to frequent cocaine use, may reduce the number of receptors related to reward and satisfaction. When cocaine use is stopped,this can lead to profound depression, exhaustion, and repetitive, purposeless motor behaviors, such as picking or tics.

Related topics: drug abuse, drug abuse and dependence, drug abuse first aid, stroke secondary to cocaine.

Prevention:

Avoid cocaine use.

Symptoms:

Primary symptoms include irritabilitywith exhaustion, generalized malaise, and often picking of the skin or motor tics. In addition to depression, individuals may suffer from guilt feelings, somatic complaints, loss of appetite (anorexia).

After the withdrawal syndrome has passed, individuals attempting to stop cocaine may fail to achieve enjoyment in activities or behaviors that were previously fun and rewarding. Craving remains a constant problem and may persist for years following the last dose of cocaine.

Signs and Tests:

Physical examination and history of cocaine use are sufficient to diagnose this condition.

Treatment:

Symptoms are treated as appropriate. Unlike other withdrawal syndromes such as alcohol, cocaine withdrawal does not progress to serious or life threatening complications, though there is a risk of suicide or compensatory overdose. Time will reduce some symptoms. Sometimes medications (sedatives) are used to reduce withdrawal symptoms.

Prognosis:

The failure rate at remaining abstinent form cocaine is estimated to be as high as 80%. Sedatives can be used to lessen the irritability and malaise. Presently there are no effective medications for reducing craving, though some are being tested.

Complications:

• Depression
• Craving and overdose
• Suicide

Because many users will abuse more than one drug, other potentially more serious withdrawal syndromes (e.g., alcohol) need to be ruled out.

Call your health care provider if you use cocaine and need help to stop using it.