THE NEUROPSYCHIATRY OF CHRONIC COCAINE ABUSE

This review integrates findings from neuropsychological, PET, and MRI studies in human subjects and neurochemical findings in animals to mak e inferences about neuropsychiatric consequences of chronic abuse of c ocaine. It also aims to develop insights into brain-behavioral relatio nships that may explain the perpetuation of addictive behaviors. Such insights promise to lend to a better understanding of the neuropsychia try of cocaine abuse and to promote the development of more efficaciou s treatments. The authors present evidence suggesting that cocaine abu sers have specific dysfunction of executive functions (decision making , judgment) and that this behavior is associated with dysfunction of s pecific prefrontal brain regions, the orbitofrontal cortex, and anteri or cingulate gyrus. Suggestions for future research and treatment are also discussed.