Pharmacotherapy of patients with schizophrenia and substance abuse

Comorbid substance-use disorder in schizophrenia patients is associated with poor clinical and functional outcome.

To provide evidence-based pharmacological treatment recommendations to improve the disease course of this patient group.

A comprehensive systematic review of the pharmacological studies in this subgroup of patients was performed and the available studies were discussed from the standpoint of evidence-based medicine.

Slight advantages were found for second-generation antipsychotic agents over conventional antipsychotics with regard to improvement of distinct psychopathological symptoms, reduced craving, and greater reduction of substance use; these findings are mainly derived from open studies or case series. Additional treatment with antidepressants, depending on the patient's psychopathology, as well as with anti-craving agents should be considered.