Stimulant Withdrawal

Cessation of (or reduction in) prolonged amphetamine-type substance, cocaine, or other stimulant use.

Dysphoric mood and at least 2 of the following physiological changes, developing within a few hours to several days after Criterion A:

1. Fatigue
2. Vivid, unpleasant dreams
3. Insomnia or hypersomnia
4. Increased appetite
5. Psychomotor retardation or agitation

The signs or symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication or withdrawal from another substance.

• Acute withdrawal symptoms (post-use “crash”) can be seen after repeated high-dose use (“binges”).
  • These periods are characterized by intense and unpleasant feelings of depression and increased appetite, and requires several days of recuperation and rest.^[1]
  • Depressive symptoms with or without suicidal ideation or behaviour can occur during the “crash.”^[2]
• Bradycardia is often present and is a reliable indicator of stimulant withdrawal.^[3]
• Anhedonia and drug craving can also be present but is not part of the diagnostic criteria.^[4]

• Stimulant use disorder and other stimulant-induced disorders
  • Stimulant withdrawal is different from stimulant use disorder and from the other stimulant-induced disorders (e.g. - stimulant-induced intoxication delirium, depressive disorder, bipolar disorder, psychotic disorder) because the symptoms of withdrawal predominate the clinical presentation and are severe enough to warrant independent clinical attention.