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Cocaine psychoses: a continuum model

Published Online:https://doi.org/10.1176/ajp.132.3.225

The author describes an orderly progression of clinical syndromes (euphoria, dysphoria, paranoid psychosis) with cocaine use that is related to dosage, chronicity, and genetic and experiential predispositions. That affective alternations are caused by a drug which also produces a schizophreniform psychosis suggests a continuum with implications for understanding the endogenous psychoses. The author emphasizes that alternations in the same neurotransmitter substances may be involved in these multiple psychiatric syndromes, which contrasts with previous "one illness, one transmitter" models.

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