This condition is similar to amphetamine psychosis and paranoid schizophrenia. In addition to the physical effects seen with short-term use, heavy use can cause mood swings, weight loss, constipation, impotence and difficulty urinating. Chronic use of cocaine can cause heart attacks, strokes, abnormal heart rhythms, and other heart muscle abnormalities. These effects on the heart and blood vessels probably account for the dramatic sudden deaths that have occurred in apparently healthy celebrity figures. Some doctors consider unexplained chest pain or heart attack in a young person as a possible indication of cocaine abuse.
Strokes can occur in young people and first-time users as well as chronic abusers.
Headaches and seizures are common complications of cocaine use. Chronic, heavy cocaine use probably causes some brain damage, but the extent of damage and the amount of impairment is not known. Some long-term cocaine abusers display disinhibition, or trouble inhibiting inappropriate behaviors. Ironically, while depression is a major symptom of cocaine withdrawal, some users take cocaine to treat an existing depression. Cocaine depresses the immune system which may result in users having more infections.