期刊
JOURNAL OF SUBSTANCE ABUSE TREATMENT
卷 34, 期 1, 页码 61-71出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.jsat.2007.01.008
关键词
schizophrenia; substance abuse; brain reward; atypical antipsychotics; clozapine
资金
- NIAAA NIH HHS [AA-014644, R03 AA014644-02, R03 AA014644, R03 AA014644-01] Funding Source: Medline
- NIDA NIH HHS [R21 DA019215-01, DA-13196, R21 DA019215-02, R01 DA013196-02, R21 DA019215, DA-019215, R01 DA013196, R01 DA013196-01, R01 DA013196-02S1] Funding Source: Medline
- NIMH NIH HHS [R21 MH062157-04, MH-62197, R21 MH062157-01A1, R21 MH062157, R21 MH062157-02, R21 MH062157-03] Funding Source: Medline
- NATIONAL INSTITUTE OF MENTAL HEALTH [R21MH062157, R01MH062197] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM [R03AA014644] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE ON DRUG ABUSE [R01DA013196, R21DA019215] Funding Source: NIH RePORTER
Substance use disorder is common in patients with schizophrenia and dramatically worsens their outcome. The typical antipsychotic medications, introduced more than 50 years ago, are effective for the treatment of psychosis but may have only limited efficacy in patients with these co-occurring disorders because patients continue to use substances while taking them. In preliminary studies, however, several of the atypical antipsychotic medications have shown promise for reducing alcohol and drug use in patients with schizophrenia. A neurobiological formulation is discussed, suggesting that the use of substances in patients with schizophrenia may be based on a dysfunction within the dopamine-mediated brain reward circuitry and that clozapine, in particular, may potentially ameliorate this dysfunction and lessen the desire for substance use. Medications for the treatment of alcohol use disorders, such as disulfiram, naltrexone, and acamprosate, as well as other adjunctive medications, may also be useful. Further studies are required to establish a solid evidence base of best practices for the use of medications in these patients. (c) 2008 Elsevier Inc. All rights reserved.
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