Management of schizophrenia and comorbid substance use disorders

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. Thi...

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Autores: Neyra, Adrián, Parro-Torres, Carlos, Ros-Cucurull, Elena, Carrera, Indalecio, Echarri, Eduardo, Torrens, Marta
Formato: artículo
Fecha de publicación:2024
País:España
Recursos:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:322321
Acesso em linha:https://ddd.uab.cat/record/322321
https://dx.doi.org/urn:doi:10.1186/s12991-024-00529-7
Access Level:acceso abierto
Palavra-chave:Schizophrenia
Substance use disorder
Comorbid disorders
Dual diagnosis
Antipsychotics
Care management
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spelling Management of schizophrenia and comorbid substance use disordersexpert review and guidanceNeyra, AdriánParro-Torres, CarlosRos-Cucurull, ElenaCarrera, IndalecioEcharri, EduardoTorrens, MartaSchizophreniaSubstance use disorderComorbid disordersDual diagnosisAntipsychoticsCare managementSchizophrenia 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. 22024-01-0120242024-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/322321https://dx.doi.org/urn:doi:10.1186/s12991-024-00529-7reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest 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.https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:3223212026-06-06T12:50:31Z
dc.title.none.fl_str_mv Management of schizophrenia and comorbid substance use disorders
expert review and guidance
title Management of schizophrenia and comorbid substance use disorders
spellingShingle Management of schizophrenia and comorbid substance use disorders
Neyra, Adrián
Schizophrenia
Substance use disorder
Comorbid disorders
Dual diagnosis
Antipsychotics
Care management
title_short Management of schizophrenia and comorbid substance use disorders
title_full Management of schizophrenia and comorbid substance use disorders
title_fullStr Management of schizophrenia and comorbid substance use disorders
title_full_unstemmed Management of schizophrenia and comorbid substance use disorders
title_sort Management of schizophrenia and comorbid substance use disorders
dc.creator.none.fl_str_mv Neyra, Adrián
Parro-Torres, Carlos
Ros-Cucurull, Elena
Carrera, Indalecio
Echarri, Eduardo
Torrens, Marta
author Neyra, Adrián
author_facet Neyra, Adrián
Parro-Torres, Carlos
Ros-Cucurull, Elena
Carrera, Indalecio
Echarri, Eduardo
Torrens, Marta
author_role author
author2 Parro-Torres, Carlos
Ros-Cucurull, Elena
Carrera, Indalecio
Echarri, Eduardo
Torrens, Marta
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv Schizophrenia
Substance use disorder
Comorbid disorders
Dual diagnosis
Antipsychotics
Care management
topic Schizophrenia
Substance use disorder
Comorbid disorders
Dual diagnosis
Antipsychotics
Care management
description 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.
publishDate 2024
dc.date.none.fl_str_mv 2
2024-01-01
2024
2024-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/322321
https://dx.doi.org/urn:doi:10.1186/s12991-024-00529-7
url https://ddd.uab.cat/record/322321
https://dx.doi.org/urn:doi:10.1186/s12991-024-00529-7
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
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