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Pharmacotherapeutic Effects of Opioid Antagonists in Alcohol-Abusing Patients with Schizophrenia

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Opiate Receptors and Antagonists

Part of the book series: Contemporary Neuroscience ((CNEURO))

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Abstract

Schizophrenia is a devastating clinical disorder that affects ~1% of the general population. The prevalence of alcohol use disorders among schizophrenic patients is greater than the rate observed in the general population. While behavioral treatments have been developed to treat patients with comorbid schizophrenia and substance use, pharmacologic management may provide another therapeutic option for these patients. The opioid antagonist naltrexone was developed and approved by the Food and Drug Administration (FDA) to treat alcohol use disorders in noncomorbid patients. More recently, there has been interest in the use of opioid antagonist treatment for patients with schizophrenia and comorbid alcohol dependence. The evidence supporting the use of naltrexone in this group is from data from heterogeneous samples of dually diagnosed patients including those with schizophrenia and schizoaffective disorder and from one randomized trial in patients with schizophrenia and schizoaffective disorder. The controlled clinical trial in patients with schizophrenia and alcohol use/dependence compared naltrexone to placebo augmentation of neuroleptic in 31 outpatients. Outcomes focused on alcohol use and craving, but also rigorously evaluated symptoms of psychosis, cognitive symptoms and side effects. The results consistently suggest that naltrexone is both safe and effective in this group of patients. Taken together, the data suggest that the opioid antagonist naltrexone may be a good therapeutic option to treat alcohol use disorders in patients with schizophrenia.

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Authors and Affiliations

  1. West Haven Veterans Administration Medical Center, #116-A, 950 Campbell Avenue, West Haven, CT, 06516

    Ismene Petrakis

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  1. Ismene Petrakis
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Editors and Affiliations

  1. Life Sciences/Toxicology, Alkermes, Inc., Cambridge, MA, 02139, USA

    Reginald L. Dean III

  2. Department of Pharmacology, College of Osteopathic Medicine, University of New England, Biddleford, ME, 04005, USA

    Edward J. Bilsky

  3. Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, 23298, USA

    S. Stevens Negus

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Petrakis, I. (2009). Pharmacotherapeutic Effects of Opioid Antagonists in Alcohol-Abusing Patients with Schizophrenia. In: Dean, R.L., Bilsky, E.J., Negus, S.S. (eds) Opiate Receptors and Antagonists. Contemporary Neuroscience. Humana Press. https://doi.org/10.1007/978-1-59745-197-0_25

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