Using Cocaine With Prescription Drugs

In our latest question and answer, the pharmacist discusses the potential dangers of cocaine use with prescription medication.

Jan 14, 2018

farid asked

Hi, I am 30 years old using serteraline (200mg)/ risperidone (3mg)/ nortiriptyline(25mg)/gabapentin (600 mg) per day. It is under my doctors supervision but I'm curious about testing cocaine. Does cocaine have interference with my drugs? I have read articles about how these drugs avoid cocaine disorder and also articles saying its a dangerous mixture. 

Answer

Recreational use of cocaine, dangerous in it's own right, should not be used in those taking prescription medication, especially medication that affects neurotransmitters in the brain.

How Cocaine Works

Cocaine use is known primarily for causing a significant and acute release of dopamine and also inhibits dopamine reuptake. The net result is an overall increase in dopamine. This causes a variety of effects including:

  • Euphoria
  • Stimulation
  • Lessened fatigue
  • Increased talkativeness
  • Sexual arousal
  • Increased mental ability
  • Alertness

In addition to dopamine, cocaine significant increases the concentrations of the neurotransmitter norepinephrine, causing a variety of effects including:

  • Vasoconstriction
  • Increased heart rate
  • Increased blood pressure

In addition to the above effects, serious, sometimes fatal effects can occur such as seizures, convulsions and cardiac arrest. When used consistently, cocaine causes a net decrease in dopamine concentrations in the brain (due to negative feedback loops) and can cause severe withdrawal effects.

Cocaine - Prescription Drug Interactions

Many of the drugs listed in the question above (sertraline, risperidone. nortriptyline, gabapentin) affect neurotransmitter levels in the brain, specifically serotonin, norepinephrine and dopamine. Significant and potentially fatal effects can occur from cocaine use, and the risk of serious effects only increases with certain prescription medication, especially the ones you listed. It would be a dangerous combination and not be advised.

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