Hostname: page-component-848d4c4894-p2v8j Total loading time: 0.001 Render date: 2024-06-02T06:23:42.627Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychopharmacology of substance misuse and comorbid psychiatric disorders

Published online by Cambridge University Press:  24 June 2014

M. T. Abou-Saleh
M. T. Abou-Saleh*
Affiliation:
South-West London and St George's NHS Trust, London, UK
*
Dr Mohammed T. Abou-Saleh, MPhil, PhD, FRCPsych, South West London and St George's NHS Trust, Glenburnie Road, London, SW17 7DJ, UK. Tel: +44 (0)20 8725–0368; Fax: +44 (0)20 8725–2914; e-mail: mabousal@sghms.ac.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

The common occurrence of comorbid substance misuse and other psychiatric disorders has challenged the diagnostic and therapeutic skills of professionals concerned with the care of patients with these dual disorders. Combined pharmacological and psychological treatment approaches have evolved empirically drawing upon standard treatments with emphasis on psychosocial approaches to substance misuse for psychotic disorders and pharmacological approaches for mood disorders. Advances in the biology of both disorders have started to inform their psychopharmacology. The specific role of atypical antipscychotics is highlighted. Further studies of the biology of comorbidity will impact the use of effective pharmaceuticals such as clozapine with dual effects on schizophrenia and substance misuse.

Keywords

comorbidpsychopharmacology substance misusepsychiatric
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 16 , Issue 1 , February 2004 , pp. 19 - 25
Copyright
Copyright © 2004 Blackwell Munksgaard

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Kessler, RC, Mccongale, KA, Zhao, Set al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry 1994;51: 8–19.CrossRefGoogle ScholarPubMed
Farrell, M, Howes, S, Bebbington, Pet al. Nicotine, alcohol and drug dependence and psychiatric comorbidity. Results of a national household survey. Br J Psychiatry 2001;179: 432–437.CrossRefGoogle ScholarPubMed
Regier, DA, Myers, JK, Kramer, M, et al. The NIMH Epidemiologic Catchment Area program. Historical context, major objectives, and study population characteristics. Arch Gen Psychiatry 1984;41: 934–941.CrossRefGoogle ScholarPubMed
Laine, TP, Ahonen, A, Rasanen, P, Tiihonen, J. Dopamine transporter availability and depressive symptoms alcohol withdrawal. Psychiatry Res 1999;90: 153–157.CrossRefGoogle ScholarPubMed
Siris, SG. Pharmacological treatment of substance-abusing schizophrenic patients. Shizophr Bull 1990;16: 111–122. CrossRefGoogle ScholarPubMed
Mcevoy, J, Freudenreich, O, Mcgee, M, Vanderzwaag, C, Levin, E, Rose, J. Clozapine decreases smoking in patients with chronic schizophrenia. Biol Psychiatry 1995;37: 550–552.CrossRefGoogle ScholarPubMed
Dose, M, Tempel, HD. Abuse potential of anticholinergics. Pharmacopsychiatry 2000;33 (Suppl. 1):43–46.CrossRefGoogle ScholarPubMed
Chambers, RA, Krystal, JH, Self, DW. A neurobiological basis for substance abuse comordibity in schizophrenia. Biol Psychiatry 2001;50: 71–83.CrossRefGoogle Scholar
Weiss, R, Najavits, L. Overview of treatment modalities for dual diagnosis patients: Pharmacotherapy, psychotherapy, and 12-step programmes. In: Kranzler, H, Rounsaville, B, eds. Dual Diagnosis and Treatment: Substance Abuse and Comorbid Medical and Psychiatric Disorders. New York, NY: Marcel Dekker Inc., 1998: 87. Google Scholar
Saxon, AJ, Calsyn, DA. Effects of psychiatric care for dual diagnosis patients treated in a drug dependence clinic. Am J Drug Alcohol Abuse 1995;21 : 303–313.CrossRefGoogle Scholar
Mcgrath, PJ, Nunes, EV, Stewart, JW, Goldman, D, Agosti, V, Ocepek-Welikson, K, Quitkin, FM. Imipramine treatment of alcoholics with primary depression: a placebo-controlled clinical trial. Arch Gen Psychiatry 1996;53: 232–240.CrossRefGoogle ScholarPubMed
Nunes, EV, Quitkin, FM, Brady, R, Stewart, JW. Imipramine treatment of methadone maintenance patients with affective disorder and illicit drug use. Am J Psychiatry 1991;148: 667–669.Google ScholarPubMed
Cornelius, JR, Salloum, IM, Cornelius, MDet al. Fluoxetine in depressed alcoholics. A double blind placebo-controlled trial. Arch Gen Psychiatry 1997;54: 700–705.CrossRefGoogle ScholarPubMed
Khantzian, EJ. The self-medication hypothesis of substance use disorders: a reconsideration and recent applications. Harv Rev Psychiatry 1997;4: 231–244.CrossRefGoogle ScholarPubMed
Noordsy, DL, Drake, RE, Teague, GBet al. Subjective experiences related to alcohol use among schizophrenics. J Nerv Ment Dis 1991;179: 410–414.CrossRefGoogle ScholarPubMed
Albanese, MJ, Khantzian, EJ, Murphy, SL, Green, AI. Decreased substance use in chronically psychotic patients treated with clozapine. Am J Psychiatry 1994;151: 780.Google ScholarPubMed
Mueser, KT, Yarnold, PR, Levinson, DF, Singh, H, Bellack, AS, Kee, K, Morrison, RL, Yadalam, KG. Prevalence of substance abuse in schizophrenia: demographical clinical correlates. Schizophr Bull, 1990;16: 31–56.CrossRefGoogle Scholar
Fadda, F, Mosca, E, Colombo, G, Gessa, GL. Effect of spontaneous ingestion of ethanol on brain dopamine metabolism. Life Sci, 1989;44: 281–287.CrossRefGoogle ScholarPubMed
Nissel, M, Nomikos, GG, Svensson, Th. Nicotine dependence, midbrain dopamine systems and psychiatric disorders. Pharm Toxicol, 1995;76: 157–162. CrossRefGoogle Scholar
Green, AL, Tsuang, MT, Schildkraut, JJ. Catecholamines, their metabolites, and response to typical and atypical neuroleptics: Toward an understanding of the mechanisms of action of neuroleptic drugs. In: Friedhoff, AJ, Amin, F, eds. Plasma Homovanillic Acid in Schizophrenia. APA Press, Inc. : 1997: 61–77. Google Scholar
Schneider, U, Leweke, FM, Mueller-Vahl, KR, Emrich, H M. Cannabiniod/ anandamide system and schizophrenia: is there evidence for association? Pharmacopsychiatry 1998;2 (Suppl. 31):110–113. Google Scholar
Leweke, F M, Fuiffrida, A, Wurster, U, Emrich, H M, Piomelli, D. Elevated endogenous cannabiniods in schizophrenia. Neuroreport, 1999 June 3;10: 1665–1669.CrossRefGoogle Scholar
Parrott, A C. Human psychopharmacology of Ecstasy (MDMA): a review of 15 years of empirical research. Hum Psychopharmacol 2001;16: 557–577.CrossRefGoogle ScholarPubMed
Landabaso, MA, Iraurgi, I, Jimenez-Lerma, JM, Calle, R, Sanz, J, Gutierrez-Fraile, M. Ecstasy-induced psychotic disorder: six month follow-up study. Eur Addict Res 2002;8: 133–140.CrossRefGoogle ScholarPubMed
Zimmet, SV, Strous, RD, Burgess, ES, Kohnstamm, S, Green, AI. Effects of clozapine on substance use in patients with schizophrenic and schizoaffective disorder: a retrospective survey. J Clin Psychopharmacol 2000;20: 94–98.CrossRefGoogle ScholarPubMed
Imperato, A, Di Chiara, G. Preferential stimulation of dopamine release in the nucleus accumbens of freely moving rats by ethanol. J Pharm Exp Ther 1986;239: 219–228. Google ScholarPubMed
Procyshyn, RM, Ihsan, N, Thompson, D. A comparison of smoking behaviours between patients treated with risperidone. Int Clin Psychopharmacol 2001;16: 291–294.CrossRefGoogle Scholar
Drake, RE, Zie, H, McHugo, CJ, Green, AI. The effects of clozapine on alcohol and drug use disorders and patients with schizophrenia. Schizophr Bull 2000;26: 441–449.CrossRefGoogle ScholarPubMed
Hasin, D, Nunes, E. Comorbidity of alcohol, drug, and psychiatric disorders. In: Kranzler, H, Rounsaville, B, eds. Dual Diagnosis and Treatment: Substance Abuse and Comorbid Medical and Psychiatric Disorders. New York, NY: Marcel Dekker Inc., 1998: 1–30. Google Scholar
Littrell, KH, Petty, RG, Hilligoss, NM, Peabody, CD, Johnson, CG. Olanzapine treatment for patients with schizophrenia and substance abuse. J Subst Abuse Treat 2001;21: 217–221.CrossRefGoogle ScholarPubMed
Casas, M, Gutierrez, M, Gilbert, J, Bobes, J, Roncero, C, Octavio, I. Risperidone in the treatment of psychotic patients with opiate abuse and dependence. Actas Esp Psiquiatr 2001;29: 380–385.Google ScholarPubMed
Green, AI, Burgess, ES, Dawson, R, Zimmet, SV, Strous, RD. Alcohol and cannabis use in schizophrenia: effects of clozapine vs. risperidone. Schizophr Res 2003;60: 81–85.CrossRefGoogle ScholarPubMed
Hasin, D, Liu, X, Nunes, E, McCloud, S, Samet, S, Endicott, J. Effects of major depression on remission and relapse of substance dependence. Arch Gen Psychiatry 2002;59: 375–380.CrossRefGoogle ScholarPubMed
Abou-Saleh, MT, Merry, J, Coppen, A. Dexamethasone suppression test in alcoholism. Acta Psychiatr Scand 1984;69: 112–116.CrossRefGoogle ScholarPubMed
Mueser, KT, Drake, RE, Wallach, MA. Dual diagnosis: a review of etiological theories. Addict Behav 1998;23: 717–734.CrossRefGoogle ScholarPubMed
Post, RM, Silberstein, SD. Shared mechanisms in affective illness, epilepsy, and migraine. Neurology 1994;44 (Suppl. 7):S37–S47.Google ScholarPubMed
Volkow, ND, Wang, GJ, Fowler, JSet al. Relationship between blockade of dopamine transporters by methylphenidate and the increases in extracellular dopamine therapeutic implications. Synapse 2002;43: 181–187.CrossRefGoogle ScholarPubMed
Anand, A, Verhoeff, P, Seneca, N, Zoghbi, SS, Seibyl, J P, Charney, DS. Brain SPECT imagine of amphetamine-induced dopamine release in euthymic bipolar disorder patients. Am J Psychiatry 2000;157: 1108–1114.CrossRefGoogle Scholar
Malcolm, R, Ballenger, JC, Sturgis, ET, Anton, R. Double-blind controlled trial comparing carbamazepine to oxazepam treatment of alcohol withdrawal. Am J Psychiatry 1989;146: 617–621.Google ScholarPubMed
MacRitchie, KA, Geddes, JR, Scott, J, Haslam, DR, Goodwin, GM. Valporic acid, valproate and divalproex in the maintenance treatment of bipolar disorder. Cochrane Database Syst Rev 2001; 3: CD003196.Google Scholar
Brady, KT, Sonne, SC, Anton, R, Ballenger, JC. Valproate in the treatment of acute bipolar affective episodes complicated by substance abuse: a pilot study. J Clin Psychiatry 1995;56: 118–121.Google ScholarPubMed
Cookson, J. Use of antipsychotic drugs and lithium in mania. Br J Psychiatry Suppl, 2001;41: s148–s156.CrossRefGoogle ScholarPubMed
Hersh, D, Modesto-Lowe, V. Drug abuse and mood disorders. In: Kranzler, H, Rounsaville, B, eds. Dual Diagnosis and Treatment: Substance Abuse and Comorbid Medical and Psychiatric Disorders. New York, NY: Marcel Dekker Inc., 1998: 177–201. Google Scholar
Ballenger, JC, Goodwin, FK, Major, LF, Brown, GL. Alcohol and central serotonin metabolism in man. Arch Gen Psychiatry 1979;36: 224–227.CrossRefGoogle ScholarPubMed
Gold, MS, Dackis, CA. New insights and treatments: opiate withdrawal and cocaine addiction. Clin Ther 1984;7: 6–21.Google ScholarPubMed
Mason, BJ, Kocsis, JH, Ritvo, EC, Cutler, RB. A double-blind, placebo-controlled trial of desipramine for primary alcohol dependence stratified on the presence or absence of major depression. JAMA 1996;275: 803–804.CrossRefGoogle ScholarPubMed
Mason, BJ. Dosing issues in the pharmacotherapy of alcoholism. Alcohol Clin Exp Res 1996;20 (Suppl. 7):10A–16A.CrossRefGoogle ScholarPubMed
Nunes, EV, McGrath, PJ, Quitkin, FMet al. Imipramine treatment of alcoholism with comorbid depression. Am J Psychiatry 1993;150: 963–965.Google ScholarPubMed
Kranzler, HR, Burleson, JA, Korner, Pet al. Placebo-controlled trial of fluoxetine as an adjunct to relapse prevention in alcoholics. Am J Psychiatry 1995;152: 391–397.Google ScholarPubMed
Schmitz, JM, Averill, P, Stotts, AL, Moeller, FG, Rhoades, HM, Grabowski, J. Fluoxetine treatment of cocaine-dependent patients with major depressive disorder. Drug Alcohol Depend 2001;63: 207–214.CrossRefGoogle ScholarPubMed
Landabaso, MA, Iraurgi, I, Jimenez-Lerma, JM, Sanz, Jet al. A randomized trial of adding fluoxetine to a naltrexone treatment programme for heroin addicts. Addiction 1998;93: 739–744.CrossRefGoogle ScholarPubMed
Gawin, FH, Kleber, HD, Byck, Ret al. Desipramine facilitation of initial cocaine abstinence. Arch Gen Psychiatry 1989;46: 117–121.CrossRefGoogle ScholarPubMed
Ziedonis, DM, Kosten, TR. Pharmacotherapy improves treatment outcome in depressed cocaine addicts. J Psychoactive Drugs Dec 1991;23: 417–425. CrossRefGoogle ScholarPubMed
Carrol, KM, Nich, C, Rounsaville, BJ. Differential symptom reduction in depressed cocaine abusers treated with psychotherapy and pharmacology. J Nerv Ment Dis 1995;183: 251–259.CrossRefGoogle Scholar