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oai:recercat.cat:11351/123812025-10-24T10:25:25Zcom_2072_378070com_2072_378040col_2072_378092

2025-10-24T10:25:24Z urn:hdl:11351/12381 Management of schizophrenia and comorbid substance use disorders: expert review and guidance Neyra, Adrián Parro-Torres, Carlos Carrera, Indalecio Echarri, Eduardo Torrens, Marta ROS-CUCURULL, ELENA Esquizofrènia - Tractament Diagnòstic dual Abús de substàncies Antipsicòtics ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Diagnosis, Dual (Psychiatry) PSYCHIATRY AND PSYCHOLOGY::Mental Disorders::Schizophrenia Spectrum and Other Psychotic Disorders::Schizophrenia PSYCHIATRY AND PSYCHOLOGY::Mental Disorders::Substance-Related Disorders HOMEOPATHY::Homeopathic Therapeutics::Classification of Homeopathic Remedies::Homeosycosics ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Clinical Decision-Making TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::diagnóstico dual psiquiátrico PSIQUIATRÍA Y PSICOLOGÍA::trastornos mentales::espectro de la esquizofrenia y otros trastornos psicóticos::esquizofrenia PSIQUIATRÍA Y PSICOLOGÍA::trastornos mentales::trastornos relacionados con sustancias HOMEOPATÍA::terapéutica homeopática::clasificación de los remedios homeopáticos::homeosicósicos TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::toma de decisiones clínicas Care management; Schizophrenia; Substance use disorder Gestió assistencial; Esquizofrènia; Trastorn per consum de substàncies Gestión asistencial; Esquizofrenia; Trastorno por consumo de sustancias Background Schizophrenia and substance use disorders (SUDs) are often comorbid conditions that present clinical challenges due to their heterogeneity and the difficulties associated with poor physical health, low medication adherence, high relapse and hospitalization rates, and increased risk of mortality. This is often exacerbated by a fragmented health care system that treats addiction and mental illness separately, leading to delays in proper diagnosis and treatment. Main text The aim of this narrative review, based on an extensive literature search and experts’ clinical experience, is to synthesize evidence on the psychopathological and clinical characteristics of patients, the burden and management at the level of healthcare system, and possible gaps in the treatment of schizophrenia with comorbid SUD in order to understand and address the needs of patients. Treatment options, differences between antipsychotic medications, and the benefits of long-acting formulations and partial dopaminergic agonists are described. Partial dopamine agonists (aripiprazole, cariprazine, and brexpiprazole) have demonstrated good control of psychotic symptoms and SUDs with a favorable safety profile. Conclusion Pharmacological interventions should be accompanied by psychosocial support within an integrated and multidisciplinary approach that promotes shared decision-making and a good therapeutic alliance between the entire medical team and the patient. The elaboration of the manuscript was supported by Otsuka Pharmaceutical S.A. and Lundbeck España S.A. 2025-10-24T10:25:24Z 2025-10-24T10:25:24Z 2025-01-08T11:25:34Z 2025-01-08T11:25:34Z 2024-10-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://hdl.handle.net/11351/12381 Annals of General Psychiatry;23 https://doi.org/10.1186/s12991-024-00529-7 Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess BMC Scientia