Atypical Antipsychotic Drugs in Dual Diagnosis Patients: A Review

Introduction: Dual Diagnosis (DD), defined as the co-occurrence of a Substance Use Disorder (SUD) and a Severe Mental Illness (SMI), is associated with several negative outcomes. Typical antipsychotics (TAP) are not of great value for patients with DD as they are associated with poorer responses and...

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Autores: Marín-Mayor, Marta, López-Álvarez, Jorge, López-Muñoz, F., Arias-Horcajadas, Francisco, Rubio, G.
Tipo de recurso: artículo
Fecha de publicación:2015
País:España
Institución:Universidad Camilo José Cela (UCJC)
Repositorio:Depósito Digital e-UCJC
OAI Identifier:oai:repositorio.ucjc.edu:20.500.12020/775
Acceso en línea:http://hdl.handle.net/20.500.12020/775
Access Level:acceso abierto
Palabra clave:Psicología
Atypical antipsychotics
Dual diagnosis
Substance use disorder
61 Psicología
3209 Farmacología
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spelling Atypical Antipsychotic Drugs in Dual Diagnosis Patients: A ReviewMarín-Mayor, MartaLópez-Álvarez, JorgeLópez-Muñoz, F.Arias-Horcajadas, FranciscoRubio, G.PsicologíaAtypical antipsychoticsDual diagnosisSubstance use disorder61 Psicología3209 FarmacologíaIntroduction: Dual Diagnosis (DD), defined as the co-occurrence of a Substance Use Disorder (SUD) and a Severe Mental Illness (SMI), is associated with several negative outcomes. Typical antipsychotics (TAP) are not of great value for patients with DD as they are associated with poorer responses and can worsen SUD. Atypical antipsychotics (AAP) offer several advantages compared to TAP. In DD, they have been found to be effective in treating both, psychiatric symptoms and substance use. The aim of this article is to review the use of AAP for treating DD patients. Methods: A search of MEDLINE, EMBASE and Pubmed was performed in order to identify publications that examined the use of AAP in the treatment of DD. Results: The largest number of studies focuse on clozapine, with consistently positive data. Data regarding aripiprazole are also consistent but less substantial. Olanzapine, risperidone and quetiapine have given inconclusive and inconsistent results. Finally, there is little use of amisulpride, ziprasidone, paliperidone and asenapine or it is has not been documented. Discussion: Today, there is a consensus on using AAT instead of TAP for treating patients with DD. Patients with DD show a poorer response to treatment with TAP, and TAP may even worsen the addictive behaviour. AAP are as effective as TAP in treating psychiatric symptoms, but they are more effective in reducing substance use in DD patients. Because with the exception of CLO none of the AAP have shown to be superior to the others, when choosing between the different AAP agents clinicians should take into account other variables such as medical comorbidity, possible pharmacological interactions of concomitant treatments and profile of side effects. Even though a growing body of evidence suggests the beneficial effects of AAP in DD patients, further randomized, blinded, controlled trials, with larger sample sizes and longer followups are needed.2015info:eu-repo/semantics/articlehttp://hdl.handle.net/20.500.12020/775reponame:Depósito Digital e-UCJCinstname:Universidad Camilo José Cela (UCJC)Inglésinfo:eu-repo/semantics/openAccessoai:repositorio.ucjc.edu:20.500.12020/7752026-05-27T07:36:51Z
dc.title.none.fl_str_mv Atypical Antipsychotic Drugs in Dual Diagnosis Patients: A Review
title Atypical Antipsychotic Drugs in Dual Diagnosis Patients: A Review
spellingShingle Atypical Antipsychotic Drugs in Dual Diagnosis Patients: A Review
Marín-Mayor, Marta
Psicología
Atypical antipsychotics
Dual diagnosis
Substance use disorder
61 Psicología
3209 Farmacología
title_short Atypical Antipsychotic Drugs in Dual Diagnosis Patients: A Review
title_full Atypical Antipsychotic Drugs in Dual Diagnosis Patients: A Review
title_fullStr Atypical Antipsychotic Drugs in Dual Diagnosis Patients: A Review
title_full_unstemmed Atypical Antipsychotic Drugs in Dual Diagnosis Patients: A Review
title_sort Atypical Antipsychotic Drugs in Dual Diagnosis Patients: A Review
dc.creator.none.fl_str_mv Marín-Mayor, Marta
López-Álvarez, Jorge
López-Muñoz, F.
Arias-Horcajadas, Francisco
Rubio, G.
author Marín-Mayor, Marta
author_facet Marín-Mayor, Marta
López-Álvarez, Jorge
López-Muñoz, F.
Arias-Horcajadas, Francisco
Rubio, G.
author_role author
author2 López-Álvarez, Jorge
López-Muñoz, F.
Arias-Horcajadas, Francisco
Rubio, G.
author2_role author
author
author
author
dc.subject.none.fl_str_mv Psicología
Atypical antipsychotics
Dual diagnosis
Substance use disorder
61 Psicología
3209 Farmacología
topic Psicología
Atypical antipsychotics
Dual diagnosis
Substance use disorder
61 Psicología
3209 Farmacología
description Introduction: Dual Diagnosis (DD), defined as the co-occurrence of a Substance Use Disorder (SUD) and a Severe Mental Illness (SMI), is associated with several negative outcomes. Typical antipsychotics (TAP) are not of great value for patients with DD as they are associated with poorer responses and can worsen SUD. Atypical antipsychotics (AAP) offer several advantages compared to TAP. In DD, they have been found to be effective in treating both, psychiatric symptoms and substance use. The aim of this article is to review the use of AAP for treating DD patients. Methods: A search of MEDLINE, EMBASE and Pubmed was performed in order to identify publications that examined the use of AAP in the treatment of DD. Results: The largest number of studies focuse on clozapine, with consistently positive data. Data regarding aripiprazole are also consistent but less substantial. Olanzapine, risperidone and quetiapine have given inconclusive and inconsistent results. Finally, there is little use of amisulpride, ziprasidone, paliperidone and asenapine or it is has not been documented. Discussion: Today, there is a consensus on using AAT instead of TAP for treating patients with DD. Patients with DD show a poorer response to treatment with TAP, and TAP may even worsen the addictive behaviour. AAP are as effective as TAP in treating psychiatric symptoms, but they are more effective in reducing substance use in DD patients. Because with the exception of CLO none of the AAP have shown to be superior to the others, when choosing between the different AAP agents clinicians should take into account other variables such as medical comorbidity, possible pharmacological interactions of concomitant treatments and profile of side effects. Even though a growing body of evidence suggests the beneficial effects of AAP in DD patients, further randomized, blinded, controlled trials, with larger sample sizes and longer followups are needed.
publishDate 2015
dc.date.none.fl_str_mv 2015
dc.type.none.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/20.500.12020/775
url http://hdl.handle.net/20.500.12020/775
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.source.none.fl_str_mv reponame:Depósito Digital e-UCJC
instname:Universidad Camilo José Cela (UCJC)
instname_str Universidad Camilo José Cela (UCJC)
reponame_str Depósito Digital e-UCJC
collection Depósito Digital e-UCJC
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.300724

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