Pharmacologic Treatments for Co-Occurring Substance Use Disorders in Patients with Schizophrenia

Abstract

Substance use disorders are a common comorbidity in patients with schizophrenia, and are associated with a variety of negative outcomes. Research assessing pharmacotherapy of substance use disorders in patients with schizophrenia is in its infancy, but preliminary data indicate that, in particular, atypical antipsychotic medications may help patients with co-occurring disorders reduce substance use. Clozapine, despite its potential side effects, shows the most promise. Data related to other medications, which may also be helpful in patients with schizophrenia, are reviewed. Further controlled trials are needed to assess the impact of atypical antipsychotics, mood stabilizers, and other agents on substance abuse in patients with schizophrenia. Until such data are avail-Mary F. Brunette, Douglas L. Noordsy, and Alan I. Green are affiliated with the Department of Psychiatry, Dartmouth Medical School. able, clinicians should follow established principles of pharmacotherapy for patients with dual disorders, which include using medications to treat both disorders simultaneously over time in the context of psychosocial treatment for dual disorders.