DSM-IV

For more information, see Substance Withdrawal

The essential feature of Cocaine Withdrawal is the presence of a characteristic withdrawal syndrome that develops within a few hours to several days after the cessation of (or reduction in) cocaine use that has been heavy and prolonged (Criteria A and B). The withdrawal syndrome is characterized by the development of dysphoric mood accompanied by two or more of the following physiological changes: fatigue, vivid and unpleasant dreams, insomnia or hypersomnia, increased appetite, and psychomotor retardation or agitation. Anhedonia and drug craving can often be present but are not part of the diagnostic criteria. These symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion C). The symptoms must not be due to a general medical condition and are not better accounted for by another mental disorder (Criterion D).

Acute withdrawal symptoms ("a crash") are often seen after periods of repetitive high-dose use ("runs" or "binges"). These periods are characterized by intense and unpleasant feelings of lassitude and depression, generally requiring several days of rest and recuperation. Depressive symptoms with suicidal ideation or behavior can occur and are generally the most serious problems seen during "crashing" or other forms of Cocaine Withdrawal. A substantial number of individuals with Cocaine Dependence have few or no clinically evident withdrawal symptoms on cessation of use.

Diagnostic Criteria

A. Cessation of (or reduction in) cocaine use that has been heavy and prolonged.

B. Dysphoric mood and two (or more) of the following physiological changes, developing within a few hours to several days after Criterion A:

  1. fatigue
  2. vivid, unpleasant dreams
  3. insomnia or hypersomnia
  4. increased appetite
  5. psychomotor retardation or agitation

C. The symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder.

DSM-5

See Stimulant Withdrawal

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