Thecomedown, orcrashing (also "down", "low", or sometimes "crash"), is a phase ofdrug withdrawal that involves the deterioration inmood and energy that occurs when apsychoactive drug, typically astimulant,[1]clears from theblood in thebloodstream. The improvement and deterioration of mood (euphoria anddysphoria) are represented in the cognitiveschema as high and lowelevations; thus, after the drug haselevated the mood (a state known as ahigh), there follows a period ofcoming back down, which often has a distinct character from withdrawal in stimulants. Generally, a comedown can happen to anyone as a transientsymptom, but in people who aredependent on the drug (especially thoseaddicted to it), it is an early symptom ofwithdrawal and thus can be followed by others.
Variousdrug classes, most especiallystimulants and, to a lesser degree,opioids andsedatives, are subject to comedowns.[2] A milder analogous mood cycle can happen even withblood sugar levels (thussugar highs andsugar lows), which is especially relevant to people withdiabetes mellitus and to parents and teachers managing children's behavior, as well as in adults withADHD, although the notion of a "sugar high" has not been verified in scientific studies and appears to be a form of confirmation bias or placebo effect. The use ofcaffeine may also be subject to periods of low energy and mood following its effects. Stimulant comedowns are unique in that they often appear very abruptly after a period of focus or high, and are typically the more intensely dysphoric phase of withdrawal than that following complete elimination from the bloodstream. Besides general dysphoria, this phase can be marked byfrustration,anger,anhedonia,social withdrawal, and other symptoms characteristic to a mildermixed episode inbipolar disorder. Alertness and other general stimulant effects are still present.
For example, in anMDMA ("ecstasy" and "molly") comedown, if the user experiences severe, persisting emotional distress, such aspanic attacks, severegeneralized anxiety, orinsomnia following an MDMA session, a physician may prescribe abenzodiazepine (specifically,lorazepam) and/orsleep aid (e.g.,zolpidem), to alleviate those effects.[3]