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Cited by 19Substance Abuse Treatment and OutcomesAlcoholism and Thiamine DeficiencyAlcohol Consumption and Health Effects

Pharmacological treatment for dual diagnosis: a literature update and a proposal of intervention

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Vitali, Mario, Mistretta, Martino, Alessandrini, Giovanni, Coriale, Giovanna, Romeo, Marina, Attilia, Fabio, Rotondo, Claudia, Sorbo, Francesca +4 more·2018·Rivista di Psichiatria
DOI 10.1708/2925.29419
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Abstract

SUMMARY. Background. It has long been appreciated that alcohol use disorder (AUD) is associated with increased risk of psychiatric disorder. As well, people with history of mental disorder are more likely to develop lifetime AUD. Nevertheless, the treatment of dual diagnosis (DD) in alcohol addiction still remains a challenge. The efficacy of pharmacological treatment for these patients has been widely investigated with controversial results. Patients with untreated psychiatric disorder are at higher risk to return to drinking and tend to do so more quickly. The aim of this review was to collect clinical data for developing guidelines for the pharmacological treatment of psychiatric diseases in a population with AUD. Materials and methods. A literature review was conducted using the following databases: PubMed-NCBI, Cochrane database, Embase Web of Science, and Scopus, including studies published between 1980 and 2015. Search terms were: “guideline”, “treatment”, “comorbidity”, “substance abuse”, “alcohol”, “dual-diagnosis”, “antidepressant”, “antipsychotic”, “mood-stabilizer”. Out of 1521 titles, 84 studies were included for their relevance on pharmacological treatment of psychiatric disorders in people with AUD. Results. Different drugs were collected in major pharmacological classes (antidepressant, mood-stabilizer, antipsychotic), in order to identify their proved efficacy for treating specific psychiatric disorder in the AUD population. Data were selected and verified for publications from randomized clinical trials, open-label trials and case reports. Conclusions. DD in alcohol dependence is a complex clinical entity, and its high prevalence is supported by epidemiological data. Pharmacological management of psychiatric disorders in patients with AUD remains partially anecdotal. Based on reviewed articles, we propose a classification of psychiatric medications for treatment of mental disorders comorbid with AUD, listed with evidence-based recommendations. More research is needed to obtain and collect clinical data, in order to organize and share evidence-based guidelines.

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Authors
Vitali, M., Mistretta, M., Alessandrini, G., Coriale, G., Romeo, M., Attilia, F., Rotondo, C., Sorbo, F., Pisciotta, F., Attilia, M. L., Ceccanti, M., & Interdisciplinary Study Group CRARL - SITAC - SIPaD - SITD -
Affiliations
  • Regione Lazio (IT)
  • Azienda Sanitaria Locale Viterbo (IT)
ORCID
Venue
Rivista di Psichiatria
Publisher
Il Pensiero Scientifico Editore
Published
2018-05-01
Volume
53
Issue
3
Pages
160-169
ISSN
0035-6484 (ISSN-L)
DOI
10.1708/2925.29419
OpenAlex
W2809185632
Cited by
19
References
0
Citations by year
2026: 1 · 2025: 3 · 2024: 1 · 2023: 4 · 2022: 3 · 2021: 4 · 2020: 2 · 2019: 1
FWCI
0.25
Type
journal article
Language
en
Open access
Locations
  • Rivista di psichiatria (publishedVersion)
  • PubMed (publishedVersion)
  • IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
  • PubMed
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Neurology › Alcoholism and Thiamine Deficiency
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
Keywords
dual diagnosis, alcoholism, psychiatric comorbidity, pharmacotherapy, antidepressants, antipsychotic drugs, mood stabilizers, treatment guidelines, evidence-based recommendations
MeSH terms
Alcohol Deterrents, Alcoholism, Anticonvulsants, Antidepressive Agents, Mental Disorders, Clinical Trials as Topic, Humans, Psychotropic Drugs, Antipsychotic Agents, Comorbidity, Practice Guidelines as Topic, Diagnosis, Dual (Psychiatry), Evidence-Based Medicine

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