Dual disorder: does expert clinical experience support the rationale for cariprazine use?

Area of Science:

• Psychiatry
• Clinical Psychology
• Neuroscience

Background:

• Comorbid substance use disorder (SUD) is common in schizophrenia patients, termed dual disorder (DD).
• DD is associated with poorer clinical outcomes and challenges in diagnosis and management.
• Existing clinical guidelines often inadequately address the complexities of co-occurring SUD and severe mental illness.

Purpose of the Study:

• To discuss common challenges in managing patients with schizophrenia and DD.
• To identify and propose best clinical practice initiatives for DD across various treatment settings.
• To suggest improvements in the clinical approach to DD in schizophrenia spectrum disorders.

Main Methods:

• Expert panel meeting in February 2023.
• Discussion of clinical experiences and common challenges.
• Identification of best practices and areas for improvement in DD management.

Main Results:

• Identified significant issues in the current clinical approach to DD.
• Proposed suitable management strategies based on expert consensus.
• Highlighted the need for integrated care models.

Conclusions:

• Individuals with DD should receive care within a single, integrated treatment center.
• Pharmacological treatment should prioritize non-sedative antipsychotics with anti-craving properties for dual symptom control.
• Integrated care is crucial for improving outcomes in patients with schizophrenia and co-occurring SUD.