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Additionally, cocaine induces apoptosis in cerebral vascular smooth muscle cells, contributing to vasoconstriction and ischemia, resulting in significant neurological damage ( 3.2 Neurological damage and psychiatric symptoms The neurological effects of cocaine include diffuse leukoencephalopathy, which is characterized by vasospasms, cerebral ischemia, and posterior reversible leukoencephalopathy ( Imaging studies have demonstrated that chronic cocaine users often exhibit brain atrophy and reduced gray and white matter volumes, particularly in the limbic regions essential for emotional processing and reward ( 3.3 Treatment strategies Calcium channel blockers, such as amlodipine, have shown promise in preventing cocaine-induced vascular toxicity by lowering blood pressure and reducing headache frequency ( 4 Synthetic cathinones Synthetic cathinones, colloquially known as bath salts, exhibit profound neurotoxic effects by affecting monoaminergic neurotransmission, oxidative stress, excitotoxicity, and neuroinflammation

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