Management of schizophrenia and comorbid substance use disorders : expert review and guidance
Neyra, Adrián (Hospital Universitario de Gran Canaria Dr. Negrín)
Parro-Torres, Carlos (Hospital General Universitario Gregorio Marañón)
Ros-Cucurull, Elena (Hospital Universitari Vall d'Hebron)
Carrera, Indalecio (Universidade de Santiago de Compostela)
Echarri, Eduardo (Hospital de Conxo (Santiago de Compostela))
Torrens, Marta (Institut Hospital del Mar d'Investigacions Mèdiques)

Data:	2024
Resum:	Schizophrenia and substance use disorders (SUDs) are often comorbid conditions that present clinical challenges due to their heterogeneity and the difficulties associated with poor physical health, low medication adherence, high relapse and hospitalization rates, and increased risk of mortality. This is often exacerbated by a fragmented health care system that treats addiction and mental illness separately, leading to delays in proper diagnosis and treatment. The aim of this narrative review, based on an extensive literature search and experts' clinical experience, is to synthesize evidence on the psychopathological and clinical characteristics of patients, the burden and management at the level of healthcare system, and possible gaps in the treatment of schizophrenia with comorbid SUD in order to understand and address the needs of patients. Treatment options, differences between antipsychotic medications, and the benefits of long-acting formulations and partial dopaminergic agonists are described. Partial dopamine agonists (aripiprazole, cariprazine, and brexpiprazole) have demonstrated good control of psychotic symptoms and SUDs with a favorable safety profile. Pharmacological interventions should be accompanied by psychosocial support within an integrated and multidisciplinary approach that promotes shared decision-making and a good therapeutic alliance between the entire medical team and the patient. The online version contains supplementary material available at 10. 1186/s12991-024-00529-7.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Schizophrenia ; Substance use disorder ; Comorbid disorders ; Dual diagnosis ; Antipsychotics ; Care management
Publicat a:	Annals of General Psychiatry, Vol. 23 (october 2024) , ISSN 1744-859X

DOI: 10.1186/s12991-024-00529-7
PMID: 39478536

9 p, 1.6 MB

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