Adrián Neyra, Carlos Parro-Torres, Elena Ros-Cucurull, Indalecio Carrera, Eduardo Echarri, Marta Torrens
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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.</p><p><strong>Main text: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.6000,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526640/pdf/","citationCount":"0","resultStr":"{\"title\":\"Management of schizophrenia and comorbid substance use disorders: expert review and guidance.\",\"authors\":\"Adrián Neyra, Carlos Parro-Torres, Elena Ros-Cucurull, Indalecio Carrera, Eduardo Echarri, Marta Torrens\",\"doi\":\"10.1186/s12991-024-00529-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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. 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引用次数: 0
摘要
背景:精神分裂症和药物使用障碍(SUDs)通常是并发症,由于其异质性以及与身体健康状况不佳、用药依从性低、复发率和住院率高以及死亡风险增加相关的困难,给临床治疗带来了挑战。而分散的医疗保健系统往往将成瘾和精神疾病分开治疗,导致正确诊断和治疗的延误,从而加剧了这种状况:这篇叙事性综述基于广泛的文献检索和专家的临床经验,旨在综合有关患者的精神病理学和临床特征、医疗保健系统层面的负担和管理以及精神分裂症合并 SUD 治疗中可能存在的差距等方面的证据,以了解和满足患者的需求。本文介绍了治疗方案、抗精神病药物之间的差异以及长效制剂和部分多巴胺能激动剂的益处。部分多巴胺受体激动剂(阿立哌唑、卡哌嗪和布来匹唑)对精神病症状和 SUD 有良好的控制作用,且安全性良好:药物干预应与社会心理支持相结合,采用多学科综合方法,促进共同决策以及整个医疗团队与患者之间的良好治疗联盟。
Management of schizophrenia and comorbid substance use disorders: expert review and guidance.
Background: 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.
Main text: 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.
Conclusion: 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.
期刊介绍:
Annals of General Psychiatry considers manuscripts on all aspects of psychiatry, including neuroscience and psychological medicine. Both basic and clinical neuroscience contributions are encouraged.
Annals of General Psychiatry emphasizes a biopsychosocial approach to illness and health and strongly supports and follows the principles of evidence-based medicine. As an open access journal, Annals of General Psychiatry facilitates the worldwide distribution of high quality psychiatry and mental health research. The journal considers submissions on a wide range of topics including, but not limited to, psychopharmacology, forensic psychiatry, psychotic disorders, psychiatric genetics, and mood and anxiety disorders.