Risk factors for severe withdrawal from stimulants include use of cocaine or methamphetamines, smoking (as crack), snorting (as cocaine chloride) or injecting it (all). Stimulant withdrawal syndrome is characterized by depression, hypersomnia, fatigue, headache, irritability, poor concentration, restlessness and, in severe cases, suicide attempts. Drug craving is prolonged and intense. Paranoia and acute psychosis may occur. Most often, no treatment other than support is needed for the initial phase of stimulant withdrawal.

Pharmacotherapy is determined by the specific symptoms. Olanzapine and Risperidone are the drugs of choice for treating a patient with symptoms of paranoid psychosis. Antidepressants such as desipramine (Norpramin) or fluoxetine (Prozac) may be useful in treating depressive symptoms; this therapy should be continued for three to six months, but because of the risk that the drug may be used in a suicide attempt, no more than one week's supply should be given at a time. Panic attacks may be treated with an antidepressant or a benzodiazepine. Drugs being investigated for the treatment of generalized withdrawal symptoms include adrenergic agonists and calcium channel blockers.
New pharmacological approaches with noradrenergic and dopaminergic enhacers such as bupropion, mirtazapine and other medications producing simmilar neurobiological actions are usually prescribed by experienced clinicians only.