Cocaine-induced psychotic disorders: presentation, mechanism, and management.
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.
a Department of Psychiatry and Behavioral Sciences , Emory University School of Medicine , Atlanta , Georgia , USA.
Yilang
Y
Tang
Nancy L
NL
Martin
Robert O
RO
Cotes
D003042:Cocaine / Q000009:adverse effects*; D019970:Cocaine-Related Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011605:Psychoses, Substance-Induced / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*
D003042:Cocaine
Cocaine-induced Psychosis; dual diagnosis; substance-induced psychotic disorder