Cocaine withdrawal from

Kantak and Miczek 1986). Amphetamine and cocaine, as well as dopaminergic agonists, increase further the already high levels of defensive responses in aggregated rats undergoing withdrawal from opiates, leading in extreme cases to the death of the subjects (Lai et al. 1971 Puri and Lai 1973). 

The treatment goals for withdrawal from ethanol, cocaine/ amphetamines, and opioids include (1) a determination if pharmacologic treatment of withdrawal symptoms is necessary, (2) management of medical manifestations of withdrawal such as hypertension, seizures, arthralgias, and nausea, and (3) referral to the appropriate program for substance abuse treatment. 

Tennant F., Sagherian A. Double-blind comparison of amantadine and bromocriptine for ambulatory withdrawal from cocaine dependence. Arch. Intern. Med. 147 109, 1987. 

Lu L., Dempsey J., Shaham Y., Hope B.T. Differential long-term neuroadaptations of glutamate receptors in the basolateral and central amygdala after withdrawal from cocaine self-administration in rats. J. Neurochem. 94 161, 2005. 

Modified and reprinted with permission from American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed.r text revision. Washington, DC American Psychiatric Association, 2000 Sofuoglu M, Dudish-Poulsen S, Poling J, et al. The effect of individual cocaine withdrawal symptoms on outcomes in cocaine users. Addict Behav 2005,30 1 125-1134 and Patten SB, Barbui C. Drug-induced depression a systematic review to inform clinical practice. Psychoth Psychosom 2004 73 207-215. 

Meil WM, Roll JM, Grimm JW, Lynch AM, See RE. 1995. Tolerance-like attenuation to contingent and noncontingent cocaine-induced elevation of extracellular dopamine in the ventral striatum following 7 days of withdrawal from chronic treatment. Psychopharmacology (Berl) 118(3) 338-346. 

Parsons LH, Koob GL, Weiss L. 1996. Extracellular serotonin is decreased in the nucleus accumbens during withdrawal from cocaine self-administration. Behav Brain Res 73(1-2) ... 

Meil WM, See RE (1996) Conditioned cue recovery of responding following prolonged withdrawal from self-administered cocaine in rats an animal model of relapse. Behav Pharmacol 7 754-763... 

Substance-Induced Anxiety Disorder. Numerous medicines and drugs of abuse can produce panic attacks. Panic attacks can be triggered by central nervous system stimulants such as cocaine, methamphetamine, caffeine, over-the-counter herbal stimulants such as ephedra, or any of the medications commonly used to treat narcolepsy and ADHD, including psychostimulants and modafinil. Thyroid supplementation with thyroxine (Synthroid) or triiodothyronine (Cytomel) can rarely produce panic attacks. Abrupt withdrawal from central nervous system depressants such as alcohol, barbiturates, and benzodiazepines can cause panic attacks as well. This can be especially problematic with short-acting benzodiazepines such as alprazolam (Xanax), which is an effective treatment for panic disorder but which has been associated with between dose withdrawal symptoms. 

It has been reported that after withdrawal from twelve-to-twenty-four-hour binges of intravenous cocaine self-administration, current thresholds for electrical brain stimulation reward are elevated in animals (Markou and Koob 1991,1992). In addition, levels of extracellular DA are decreased in Acb following withdrawal from prolonged cocaine self-administration (Weiss et al. 1992b). Long-term cocaine use can decrease tyrosine hydroxylase levels, leading to decreased DA synthesis (Trulson et al. 1987). 

Robertson, Matthew W., Catherine A. Leslie, and James P. Bennett. 1991. "Apparent Synaptic Dopamine Deficiency Induced by Withdrawal from Chronic Cocaine Treatment." Brain Research 538 337-39. 

Individuals who are addicted to benzodiazepines should not try to quit cold turkey on their own. Often, individuals addicted to a benzodiazepine have an addiction to another substance or drug, such as cocaine or alcohol. These multiple addictions are complicated. Recovery from these addictions should not be attempted alone. Withdrawal from abuse of benzodiazepines may cause life-threatening complications. 

The diagnosis of GHB withdrawal may be difficult because it is similar to sedative or alcohol withdrawal syndromes, as well as to withdrawal from sympathomimetic agents such as cocaine, methamphetamine, and ecstasy. GHB withdrawal may also be confused with serotonin syndrome (a reaction caused by a combination of drugs, one of which increases serotonin levels in the body, such as Prozac) and neuroleptic malignant syndrome (a rare reaction to an antiseizure medication). 

The nature of the withdrawal symptoms depends upon the neurotransmitter systems which are the target of the drug. Thus cocaine and the amphetamines alleviate fatigue, cause anorexia and elevate mood withdrawal therefore results in feelings of fatigue, hyperphagia and depression. Abrupt withdrawal from the sedatives, such as barbiturates or following... 

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