Schizophrenia with comorbid substance use disorder – treatment possibilities
Authors:
Libor Ustohal
Authors‘ workplace:
Psychiatrická klinika LF MU a FN Brno Ústav farmakologie a toxikologie, Farmaceutická fakulta MU, Brno
Published in:
Čes. a slov. Psychiat., 121, 2025, No. 5, pp. 216-221.
Category:
Review
doi:
https://doi.org/10.48095/cccsp202517
Overview
The occurrence of schizophrenia with comorbid substance use disorder is relatively common and its frequency is increasing over time. Sometimes, the term dual diagnosis is used in this context, although it does not have a completely unambiguous definition. Atypical antipsychotics, especially dopamine receptor partial agonists, are preferably used in therapy, and in patients with co-occurring treatment-resistance, the best choice is clozapine. Long-acting injectable antipsychotics, especially atypical ones, are advantageous in patients with low compliance. Recently, the special importance of the D3 receptor and its role in substance use disorders has been mentioned. Of the available dopamine receptor partial agonists (aripiprazole, brexpiprazole, cariprazine), cariprazine has the highest affinity for this receptor, so it appears to be a promising antipsychotic in the treatment of schizophrenia with comorbid substance use disorder. This is proven by the first studies, especially in patients with schizophrenia using cannabis or cocaine.
Keywords:
comorbidity – Antipsychotics – Schizophrenia – treatment – substance use disorder – dual diagnosis – cariprazine
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Addictology Paediatric psychiatry PsychiatryArticle was published in
Czech and Slovak Psychiatry
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