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Chronic cocaine use as a neuropsychiatric syndrome: A model for debate
Author(s) -
Cadet Jean Lud,
Bolla Karen I.
Publication year - 1996
Publication title -
synapse
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.809
H-Index - 106
eISSN - 1098-2396
pISSN - 0887-4476
DOI - 10.1002/(sici)1098-2396(199601)22:1<28::aid-syn3>3.0.co;2-k
Subject(s) - neuropsychology , psychiatry , medicine , disconnection , psychology , substance abuse , mood , cognition , political science , law
In humans, chronic cocaine abuse is associated with changes in the central nervoussystem (CNS). Neuropathological changes include cerebrovascular events, EEG abnormalities,vasculitis, seizures, and decrements in neurobehavioral performance. The acute administrationof cocaine is associated with acute psychotic episodes and paranoid states while withdrawalfrom the drug is often associated with depressed mood. The mechanistic basis of thesebehavioral states is not known. Given the structural and functional changes associated withcocaine use, we propose that the chronic heavy use of cocaine may result in aneuropsychiatric syndrome which might be associated with neuropsychological changes thatare not obvious during routine clinical evaluation of drug‐using individuals. Thisdisconnection syndrome, because of its sublety, might have deleterious effects on both acuteand long‐term therapeutic interventions with these subjects. An approach which deals withcocaine abuse as a neuropsychiatric disorder might be more beneficial to the long‐term goalof treating these patients. This approach entails a neurobehavioral evaluation which will becomprised of a thorough neurological and psychiatric examination, neuropsychological testing,and imaging studies. The results of this evaluation would provide a more rational basis forcognitive and/or pharmacological therapies. (The article is a US Government work and, assuch, is in the public domain in the United States of America.) © 1996 Wiley‐Liss,Inc.