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Pharmacotherapy of Dual Disorders

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Co-occurring Addictive and Psychiatric Disorders

Abstract

This chapter gives a short overview on the comorbidity and clinical correlates of substance use in affective and anxiety disorders, as well as in schizophrenia. The emphasis is on pharmacotherapies available for the treatment of comorbid disorders. While no specific drugs have been developed for comorbid substance use disorders, psychotropic drugs such as antidepressants or antipsychotics have been tested in dual disorder patients, as well as anticraving compounds. Most studies have included few patients. Very few randomized controlled trials are available in the dual disorder research field. Thus, the empirical basis for evidence-based recommendations is rather limited. The possible benefits of available medications so far are discussed.

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Abbreviations

BD:

Bipolar disorder

BZD:

Benzodiazepines

CBT:

Cognitive-behavioral therapy

CRF:

Corticotrophin-releasing factor

EPMS:

Extrapyramidal symptoms

FES:

First-episode schizophrenia

FGA:

First-generation antipsychotics

GAD:

Generalized anxiety disorder

HPA:

Hypothalamic–pituitary–adrenocortical

IPT:

Interpersonal Group Psychotherapy

LAI:

Long-acting injectable

MAOIs:

Irreversible monoamine oxidase inhibitors

mPFC:

Medial prefrontal cortex

NICE:

National Institute of Health and Clinical Excellence

PANSS:

Positive and Negative Syndrome Scale

PD:

Panic disorder

PET:

Positron emission tomography

RCT:

Randomized, controlled trial

RIMA:

Reversible inhibitor of monoamine oxidase A

SAD:

Social anxiety disorder

SFBN:

Stanley Foundation Bipolar Network

SGA:

Second-generation antipsychotics

SSRIs:

Selective serotonin reuptake inhibitors

SNRIs:

Selective serotonin noradrenaline reuptake inhibitors

SUD:

Substance use disorders

TCAs:

Tricyclic antidepressants

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Authors and Affiliations

  1. Department of Psychiatry, Ludwig Maximilian University Munich, Munich, Germany

    Michael Soyka

  2. Private Hospital Meiringen Willigen, Meiringen, Switzerland

    Michael Soyka

  3. Institute of Neuroscience, Academic Psychiatry, Campus of Aging and Vitality, Wolfson Research Centre, Newcastle University, Newcastle upon Tyne, UK

    Heinz Grunze

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  1. Collaborative Psychiatric Research Institute, Antwerp University PC Alexian Brothers Boechout, Boechout, Belgium

    Geert Dom

  2. Clinical Psychological Service and Department, University Hospital of Psychiatry & University of Bern, Bern, Switzerland

    Franz Moggi

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Soyka, M., Grunze, H. (2015). Pharmacotherapy of Dual Disorders. In: Dom, G., Moggi, F. (eds) Co-occurring Addictive and Psychiatric Disorders. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-45375-5_19

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