cocaine use can result in a whole range of psychological and psychiatric problems. It can cause marked changes in moods and behaviour. It can also exacerbate an underlying psychiatric problem
patients can become frankly psychotic on cocaine
anxiety and depression
marked increase in anxiety and irritability, especially when withdrawing after a session of use
reduction in dopamine and serotonin can cause anxiety and chemical depression
can lead to self harming, suicidal ideation and suicide
crack could be taken to self-medicate underlying depression, but may also precipitate mania and intensify the depression
care must be taken with antidepressants and only used if underlying depression confirmed
fear, paranoid ideation and cocaine-induced psychosis
excited/agitated delirium can result after a bout of heavy use. The time it lasts varies between patients and consists of agitated and bizarre behaviour, hyperthermia and extreme paranoia
tactile hallucinations are characteristic of stimulant use – the ‘cocaine bug’ – this may cause obsessive skin-picking
cocaine used to modify mood in schizophrenia, bipolar disorders, personality disorders and unrecognised ADHD
schizophrenia
can worsen the condition or act to modify mood, especially against the unwanted effects of the major tranquillisers or against the negative symptoms of schizophrenia
bipolar disorders
increased amounts taken during manic phase, but also used to self-medicate against depression
personality disorders
used to manage abnormal mood states.
Attention Deficit Hyperactivity Disorder (ADHD)
cocaine may be used by people with undiagnosed or diagnosed ADHD to increase attention span and concentration
eating disorders
associated with anorexia nervosa, as it acts and can be used as an appetite suppressant
other addictions
patient can develop an opiate, alcohol or benzodiazepine problem when these drugs are used as relaxants after a bout of cocaine use
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