The spectrum of cocaine abuse and its treatment.

There is as yet no definitive treatment for cocaine abusers, nor is there consensus as to their degree of psychopathology. Some researchers have found a high incidence of major affective and bipolar disorders, while others have not. Psychological treatment consists of behavioral, supportive, and psychodynamic approaches, with the choice based on the severity of the cocaine abuse. Experimental pharmacologic approaches using tricyclic antidepressants, lithium, or stimulants are being tried both as diagnosis-specific agents and as general treatment adjuncts, but no adequate controlled trials have yet been published.