Possible Interaction: Adrenergic Beta-Antagonists and Cocaine

“ Beta blockers must be avoided in cocaine and amphetamine poisoning.”

“We recorded the worst association of cocaine and beta-blockers by direct and indirect action, particularly at postsynaptic levels on dopamine and norepinephrine reuptake, sympathetic activation and increase of heart rate, blood pressure and cardiovascular toxicity.”

“ Betablockers have been successfully used to counter both the CNS and peripheral adverse effects of cocaine and methamphetamine but have been reported to cause “unopposed alpha-stimulation” in some patients, which may exacerbate vasoconstriction and/or hypertension [2-6].”

“Additionally, the pharmacologic agents, such as beta-adrenergic antagonists , which are often required to achieve the target heart rate, may induce life-threatening vasoconstriction in patients with active cocaine use.”

“The use of beta-blockers in cocaine induced acute coronary syndrome has long been a matter of debate.”

“While it is widely believed that beta-blockers are contraindicated in cocaine toxicity, there appears to be some recognizable role for certain beta-blockers in ameliorating the cardiovascular as well as central nervous system effects of cocaine.”

“If long-term beta-blockade is warranted, its benefits should be weighed against recurrent use of cocaine and possible exacerbation of acute coronary syndrome.”

“The clinical bottom line is that Beta Blockers should not be used in the treatment of cocaine induced myocardial ischaemia.”

“Intra-mPFC injection of an α1 adrenoceptor antagonist attenuated the stress-induced enhancement of cocaine CPP.”

“Intra‐laterodorsal tegmental nucleus (LDT) microinjection of a β or α2 adrenoceptor antagonist attenuated the stress‐induced enhancement of cocaine CPP.”

“While some clinical studies have examined the ability of LTCC blockers to alter cocaine ’s subjective effects, very few LTCC studies have examined cocaine relapse.”