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Articles   |    
The Effects of Cocaine on Depressed Patients
ROBERT M. POST; JOEL KOTIN; FREDERICK K. GOODWIN
Am J Psychiatry 1974;131:511-517.
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Chief, 3-West Clinical Research Unit, Adult Psychiatry Branch, National Institute of Mental Health, Bethesda, Md.

Chief, Section on Psychiatry, Laboratory of Clinical Science, National Institute of Mental Health, Bethesda, Md.

Assistant Adjunct Professor, Department of Psychiatry and Human Behavior, School of Medicine, University of California, Irvine, Calif.

1974, The American Psychiatric Association

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Abstract

Cocaine, administered orally to patients with endogenous depressive illness, did not consistently affect vital signs or depressive symptomatology, but it did decrease rapid eye movement sleep and total sleep time. When administered intravenously in the context of a therapeutic interview, cocaine caused large, rapid increases in pulse and blood pressure concomitant with profound mobilization of affect and tearfulness. Infusions that caused lesser changes in vital signs were associated with milder degrees of affective change and less dysphoria. Thus, while cocaine was capable of eliciting positive affective change (such as calmness and elation) in depressed patients, affective flooding and dysphoric components were often admixed, indicating that cocaine's effect in this context could not be classified simply as antidepressant.

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