Key result
Intranasal cocaine progressively decreased sympathetic nerve discharge to a nadir of 2% of baseline over 60 minutes, a reflex response to increased blood pressure that overrides cocaine's central excitatory effects.
Why the study?
Does intranasal cocaine increase or decrease sympathetic nerve discharge in healthy humans?
Population
14 healthy male volunteers, 24-44 years of age, normotensive, with no history of cardiovascular disease…
Comparison
Intranasal cocaine administered slowly to both… vs Intranasal lidocaine as an internal local…
Design
RCT, Randomly assigned to receive intranasal cocaine or lidocaine…
Follow-up
90 minutes
Authors
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Alerts clinicians to sympathoexcitation in cocaine emergencies; leaves open mechanisms and interventions for targeted study.
RCT (n=14)
Randomly assigned
No
Does intranasal cocaine increase or decrease sympathetic nerve discharge in healthy humans?
Absolute Event Rate: 4% vs 291%
p-value: p=<0.05
Intranasal cocaine exerts a primary excitatory effect on central sympathetic outflow in humans, which is normally overridden by a baroreflex-mediated decrease in sympathetic discharge due to the concurrent rise in blood pressure.
Jacobsen et al. (1997) conducted an RCT in Healthy volunteers (n=14). Intranasal cocaine vs. Intranasal lidocaine was evaluated on Sympathetic nerve discharge (total activity units/min) (p=<0.05). Intranasal cocaine progressively decreased sympathetic nerve discharge to a nadir of 2% of baseline over 60 minutes, a reflex response to increased blood pressure that overrides cocaine's central excitatory effects.
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