Cocaine, amphetamine, or similarly acting sympathomimetic withdrawal progresses through several stages and is characterized by irritability, anxiety, depression, possible suicidal ideations, fatigue, cravings, insomnia, hypersomnia, or psychomotor agitation due to stopping frequent doses, or reducing the amount used of a stimulant drug.

The initial "crash" is followed in one to four hours by intense cravings, prolonged sleep that may be interrupted to eat large amounts of food, numbness of the throat, diaphoresis, tachycardia, and abdominal cramps.

These symptoms, not due to other physical or mental disorders, last longer than 24 hours after cessation of stimulant use, and usually peak in two to four days, although depression and irritability may last for months.

Cravings can occur after months or even years of abstinence and appear to be "conditioned" in that they are triggered by events, either internal or external, that the patient associates with stimulant use. If the patient remains abstinent, the cravings will be less after each exposure. Neonatal cocaine withdrawal is similar to opiod withdrawal except that it is usually mild to moderate.

Treatment considerations:

Stimulant overdose can produce cardorespiratory distress and seizures. Life support and the administration of thiamine, glucose, oxygen and naloxone are indicated. Naloxone is an opiod antagonist that blocks the opiod receptor sites in the body, and is given because narcotics are often taken along with cocaine or amphetamines.

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