Pharmacotherapy of patients with schizophrenia and substance abuse.
BACKGROUND
Comorbid substance-use disorder in schizophrenia patients is associated with poor clinical and functional outcome.


OBJECTIVE
To provide evidence-based pharmacological treatment recommendations to improve the disease course of this patient group.


METHODS
A comprehensive systematic review of the pharmacological studies in this subgroup of patients was performed and the available studies were discussed from the standpoint of evidence-based medicine.


CONCLUSIONS
Slight advantages were found for second-generation antipsychotic agents over conventional antipsychotics with regard to improvement of distinct psychopathological symptoms, reduced craving, and greater reduction of substance use; these findings are mainly derived from open studies or case series. Additional treatment with antidepressants, depending on the patient's psychopathology, as well as with anti-craving agents should be considered.
Wobrock
Thomas
T
Georg-August-University, Department of Psychiatry and Psychotherapy, Von-Siebold Strasse 5, D-37075 Göttingen, Germany.
Soyka
Michael
M
D000427:Alcohol Deterrents / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use*; D018692:Antimanic Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D017831:Diagnosis, Dual (Psychiatry); D004221:Disulfiram / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D006801:Humans; D012559:Schizophrenia / Q000150:complications / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D019966:Substance-Related Disorders / Q000150:complications / Q000188:drug therapy* / Q000523:psychology
D000427:Alcohol Deterrents; D000928:Antidepressive Agents; D018692:Antimanic Agents; D014150:Antipsychotic Agents; D004221:Disulfiram