Treatment of schizophrenia in subjects with substance use disorders

Background: Schizophrenic patients have a high comorbidity with substance use disorders. However, there are few studies on the efficacy of antipsychotics on psychopathology and on their repercutions on substance abuse. Methods: All studies about pharmacological treatment of schizophrenic patients with substance abuse, included in Medline over the last ten years were analyzed. Results: Of the 17 studies reviewed, most were prospective with small samples (< 30 patients, 5 studies) or case reports (7 studies). Objetives were to assess the efficacy on schizophrenic symptoms and the effect of the treatment on substance use. Atypical antipsychotics were the most studied. These pharmacological agents mere effective at reducing symptoms and had few side effects. They also managed to reduce substance abuse in 66-75% of patients. Conclusions: In spite of underlyng methodological problems of these studies, the findings suggest that atypical antipsychatics could be the treatment of choice in these patients.