Relapse to cocaine abuse after initiating desipramine treatment.

Three cocaine abusers who had been abstinent for one to six months relapsed to cocaine use soon after beginning desipramine hydrochloride therapy. The antidepressant treatment was begun for different reasons in each case. All three patients developed what has been termed the early tricyclic jitteriness syndrome. This reaction may have stimulated conditioned craving for cocaine because of the similarity between this syndrome and cocaine intoxication. Since desipramine is being used to reduce cocaine craving, it is important to recognize this paradoxical increase in craving as a potential adverse effect of desipramine.