SELECTIVE SENSITIZATION TO THE PSYCHOSIS-INDUCING EFFECTS OF COCAINE - A POSSIBLE MARKER FOR ADDICTION RELAPSE VULNERABILITY

Patients in inpatient rehabilitation for uncomplicated cocaine depende nce were asked whether, compared with the time of their first regular use, they could now identify changes in the effects of similar doses o f cocaine. We asked about a spectrum of cocaine effects ''then'' and ' 'now'' and whether the same amount of drug caused effects to occur to about the same degree, less intensely (tolerance), or more intensely ( sensitization). Nearly half our sample developed predominantly paranoi d psychoses in the context of cocaine use. Sensitization was consisten tly linked only to psychosis-related cocaine effects. It hits been pro posed that mesolimbic dopaminergic sensitization might contribute to a ddiction severity. A preliminary followup of patients who were sensiti zed or nonsensitized to psychosis development suggests that rehospital ization for treatment of addiction may be more frequent in the sensiti zed group. (C) 1997 American Institute of Neuropsychopharmacology.