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Amnesia, dissociative disorders and delirium: Pathology review
Childhood and early-onset psychological disorders: Pathology review
Dementia: Pathology review
Developmental and learning disorders: Pathology review
Drug misuse, intoxication and withdrawal: Alcohol: Pathology review
Drug misuse, intoxication and withdrawal: Hallucinogens: Pathology review
Drug misuse, intoxication and withdrawal: Other depressants: Pathology review
Drug misuse, intoxication and withdrawal: Stimulants: Pathology review
Eating disorders: Pathology review
Malingering, factitious disorders and somatoform disorders: Pathology review
Mood disorders: Pathology review
Personality disorders: Pathology review
Psychiatric emergencies: Pathology review
Psychological sleep disorders: Pathology review
Schizophrenia spectrum disorders: Pathology review
Trauma- and stress-related disorders: Pathology review
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Cocaine, sometimes called coke, is a powerful psychoactive stimulant that alters how the brain functions—specifically, how we perceive our surroundings.
Cocaine comes from the leaves of the South American coca plant, and has been used for over a thousand years.
In modern times, it’s become a popular “party drug” because cocaine reduces inhibitions and creates a feeling of euphoria or pleasure; this feeling lasts between fifteen and ninety minutes, depending on how the drug’s it’s administered.
To understand how cocaine works, let’s zoom into one of the synapses of the brain.
Normally, electrical signals, or action potentials, travel down the axon to the axon terminal, where they trigger the release of chemical messengers called neurotransmitters from synaptic vesicles into the synapse.
The neurotransmitters travel across the synapse and bind to receptors on the postsynaptic neuron, where they give the cell a message.
After the neurotransmitters have done their job, they unbind from the receptors, and can just diffuse away, get degraded by enzymes, or get picked up by proteins and returned to their release site in a process called reuptake.
Cocaine increases the release of certain neurotransmitters, but it’s biggest effect is blocking reuptake receptors on presynaptic axon terminals.
For example, increased concentrations of dopamine in the brain’s reward pathway (which includes the nucleus accumbens, ventral tegmentum, and prefrontal cortex) produce intense feelings of euphoria, pleasure, and the emotional “high” associated with cocaine.
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