Recent research has produced encouraging preliminary data on general pharmacological treatments for cocaine abuse as well as on pharmacotherapies specific for cocaine abusers with Axis 1 psychiatric disorders. Pharmacotherapy trials with antidepressants, lithium, and stimulants in chronic cocaine abusers as well as recent clinical, diagnostic, and pre-clinical studies will be reviewed. Symptom presentation, severity of abuse, and phase of recovery are discussed as potential guides in treatment selection.