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Vol. 283, Issue 1, 164-176, 1997
Department of Pharmacology and Toxicology, Institut Municipal
d'Investigació Mèdica (IMIM), Autonomous University of
Barcelona, Barcelona, Spain
The effects of 100 mg of intranasal cocaine in acute alcohol
intoxication (0.8 g/kg) were evaluated in eight experienced and nondependent healthy volunteers in a double-blind double-dummy, controlled, randomized, crossover clinical study. The combination of
alcohol and cocaine produced greater increases in HR, rate-pressure product and pleasurable-related subjective effects (euphoria, well-being) compared with the effects of cocaine. The drug combination reduced the alcohol-induced sedation, but feelings of drunkenness were
not significantly counteracted. Cardiovascular changes induced by the
combination condition caused an increase in myocardial oxygen
consumption that may be related to an increased risk of cardiovascular
toxicity. The augmented subjective euphoria may explain why the drug
combination is more likely to be abused than is cocaine or alcohol
alone. Plasma cortisol concentrations were significantly higher after
concomitant alcohol and cocaine use than with cocaine alone. The
administration of cocaine did not alter alcohol-induced
hyperprolactinemia. Although cocaine produced a slight decrease in
plasma concentrations of prolactin when administered alone, it did not
antagonize the effects of alcohol on prolactin secretion when alcohol
and cocaine were given simultaneously. The combination increased
cocaine and norcocaine plasma concentrations, and induced the synthesis
of cocaethylene and norcocaethylene. The enhancement of cocaine effects
in the drug combination may be due to initially increased cocaine
plasma levels followed by the additive effect of cocaethylene, although
a pharmacodynamic interaction could not be excluded.
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