Clinical features of cocaine-induced paranoia

Article Abstract:

To study the relationship between cocaine abuse and paranoia, 50 cocaine-abusing male patients from various ethnic backgrounds (with an average age of 34 years) who were admitted to a cocaine rehabilitation program were evaluated. Patients diagnosed with psychotic disorders or affective (mood) disorders were excluded from the study. Methods and patterns of cocaine use and the nature of paranoid experience were assessed by clinical and written interviews and a questionnaire. The patients were placed into one of two groups, depending on whether they developed cocaine-induced paranoia or not. The groups were compared on demographic and drug use factors. No ethnic differences were found in terms of age at first use of cocaine, duration of use or the probability of becoming paranoid. Sixty-eight percent of the patients developed transient paranoid episodes during binge use of cocaine (sustained use lasting between 8 and 72 hours). Fifty-three percent of the 34 paranoid men acted on their paranoia by locking doors, scanning windows, hiding or refusing to move. Thirteen patients armed themselves with guns or knives. Seventy-six percent of the paranoid patients claimed that binge paranoia was more intense and manifested earlier after long-term cocaine use. Paranoid and nonparanoid patients did not differ in terms of age or method of cocaine use. Although binge-limited paranoia was prevalent in most patients, results suggest that it is not related to quantity, method of use or threshold level, but that it intensifies with long-term use. Many paranoid patients also reported a past history of hallucinogen use. However, the specific vulnerability to transient paranoia after prolonged cocaine use is not fully understood. (Consumer Summary produced by Reliance Medical Information, Inc.)

Paranoid disorders, Paranoia, Paranoid personality disorder

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Clinical phenomenology and neurobiology of cocaine abstinence: a prospective inpatient study

Article Abstract:

It is not known for sure what, if any, consequences of cocaine withdrawal are experienced by heavy users who abruptly stop. Until the early 1980s the possibility that a withdrawal syndrome for cocaine was largely discounted. More recent evidence suggests that one might exist, but documentation has been limited. To study this further, 19 male and 3 female inpatients who had used cocaine within the prior 24 hours were observed for three drug-free weeks. Several scales were completed measuring psychological variables, physical symptoms, and blood samples were analyzed three times per week for growth hormone (GH), prolactin (a hormone associated with growth hormone), and homovanillic acid (HVA; a metabolite of neurotransmitter synthesis.) Levels of GH and prolactin were compared with those of normal matched subjects as well. Symptom ratings were mildly elevated from normal at first evaluation, but by three weeks most symptoms had significantly remitted. Prolactin levels in the blood increased somewhat over the period, but GH and HVA levels remained unchanged. It is suggested that withdrawal symptoms following discontinuation of cocaine use are relatively mild and decrease with time. The results indicate that it is probably unnecessary to use drugs as part of inpatient treatment programs for cocaine dependence. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Physiological aspects, Drug withdrawal symptoms, Substance withdrawal syndrome

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Seasonal cocaine abuse

Article Abstract:

Two patients with seasonal affective disorder (SAD; a condition of moodiness affected by seasonal changes) had fluctuations in cocaine craving that occurred simultaneously with seasonal disquiet or restlessness (dysphoria). This extends the range of disorders associated with cocaine use. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug abuse, Seasonal affective disorder

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