Abstract

REVILLA-ZUNIGA, Joshep; RIVERA-ENCINAS, María Teresa  and  CRUZADO, Lizardo. Cocaine-induced psychosis as a misdiagnosis in a patient with schizophrenia and coca leavechewing. Rev Neuropsiquiatr [online]. 2016, vol.79, n.2, pp.119-126. ISSN 0034-8597.

In Peru, there is a high prevalence of stimulant use disorders and thus, although no accurate statistics are available, multiple cases of psychoses induced by cocaine hydrochloride and cocaine paste intake may occur. Moreover, chewing of dry coca leaves is part of the cultural and historical heritage of a large segment of the Peruvian population. On the basis of a case of psychiatric misdiagnosis (a primary schizophrenic psychosis in a chewer of coca leaves, misdiagnosed as cocaine-induced psychosis based on an positive test of urinary cocaine metabolites), we review pertinent literature on the clinical presentation of cocaine-induced psychosis and its differential diagnosis with other psychoses, and the characteristics of the laboratory tests used for the detection of cocaine and its metabolites. As a conclusion, the suggestion is made that health and mental health workers should have more information and knowledge about the phenomena associated with the consumption of coca leaves and cocaine, in order to avoid misdiagnosis similar to the reported case.

Keywords : Schizophrenia; psychoses; substance-induced; coca; diagnostic errors.

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