Antipsychotic Medications for People with Both Psychosis and Substance Use Disorders
In a review of 41 studies of dual diagnosis patients, cannabis was the most commonly abused substance, and aripiprazole was the most frequently used antipsychotic, particularly in long-acting injectable form.
Quick Facts
What This Study Found
Across 41 studies, most dual diagnosis patients were male with schizophrenia, and cannabis was the most abused substance followed by alcohol. Aripiprazole (oral and long-acting) was the most commonly used second-generation antipsychotic, followed by risperidone, clozapine, olanzapine, and quetiapine.
Key Numbers
41 articles reviewed; cannabis most common substance; aripiprazole most used SGA; long-acting formulations increasingly studied
How They Did This
Literature search of PubMed and Scopus for studies of second-generation antipsychotics in patients with co-occurring psychotic disorders and substance use disorders, without time restrictions.
Why This Research Matters
Dual diagnosis is common but undertreated. Knowing which antipsychotics have been studied and which substances are most prevalent helps clinicians make informed treatment decisions for these complex patients.
The Bigger Picture
The high prevalence of cannabis as the primary substance in dual diagnosis highlights the need for treatments that address both psychosis and cannabis use simultaneously, rather than treating each in isolation.
What This Study Doesn't Tell Us
Review of heterogeneous studies with varying methodologies. Most studies were not specifically designed to compare antipsychotics head-to-head in dual diagnosis patients.
Questions This Raises
- ?Which antipsychotic is most effective at reducing both psychotic symptoms and cannabis use?
- ?Would long-acting injectable antipsychotics improve treatment adherence in this population?
Trust & Context
- Key Stat:
- Cannabis was the most abused substance in dual diagnosis
- Evidence Grade:
- Systematic review of 41 studies, but heterogeneous study designs and lack of head-to-head comparisons limit definitive treatment recommendations.
- Study Age:
- Published in 2022
- Original Title:
- Atypical Antipsychotic Drugs in Dual Disorders: Current Evidence for Clinical Practice.
- Published In:
- Current pharmaceutical design, 28(27), 2241-2259 (2022)
- Authors:
- Martinotti, Giovanni(18), Chiappini, Stefania(6), Mosca, Alessio, Miuli, Andrea, Santovito, Maria Chiara, Pettorruso, Mauro, Skryabin, Valentin, Sensi, Stefano L, Giannantonio, Massimo Di
- Database ID:
- RTHC-04045
Evidence Hierarchy
Analyzes all available research on a topic using a structured method.
What do these levels mean? →Frequently Asked Questions
What is the best antipsychotic for people who use cannabis and have psychosis?
Aripiprazole was the most studied in this population, available in both oral and long-acting injectable forms. However, the review noted that more head-to-head studies are needed to determine which antipsychotic is most effective.
Why is cannabis the most common substance in dual diagnosis?
The review found cannabis was the most frequently abused substance among people with both psychotic disorders and substance use, followed by alcohol. This reflects both the high prevalence of cannabis use and its known associations with psychosis.
Read More on RethinkTHC
- THC-amygdala-anxiety-brain
- anandamide-weed-withdrawal
- cannabinoid-receptors-recovery-time
- cannabis-developing-brain-teenagers
- cant-enjoy-anything-without-weed
- dopamine-recovery-after-quitting-weed
- endocannabinoid-system-explained-simply
- endocannabinoid-system-withdrawal
- nervous-system-weed-withdrawal-fight-flight
- teen-weed-use-under-18-effects-brain
- thc-brain-withdrawal
- thc-prefrontal-cortex-brain-effects
- weed-cortisol-stress-hormones
- weed-memory-loss-recovery
- weed-motivation-amotivational-syndrome
- weed-nervous-system-effects
- weed-reward-system-brain
Cite This Study
https://rethinkthc.com/research/RTHC-04045APA
Martinotti, Giovanni; Chiappini, Stefania; Mosca, Alessio; Miuli, Andrea; Santovito, Maria Chiara; Pettorruso, Mauro; Skryabin, Valentin; Sensi, Stefano L; Giannantonio, Massimo Di. (2022). Atypical Antipsychotic Drugs in Dual Disorders: Current Evidence for Clinical Practice.. Current pharmaceutical design, 28(27), 2241-2259. https://doi.org/10.2174/1381612828666220623092853
MLA
Martinotti, Giovanni, et al. "Atypical Antipsychotic Drugs in Dual Disorders: Current Evidence for Clinical Practice.." Current pharmaceutical design, 2022. https://doi.org/10.2174/1381612828666220623092853
RethinkTHC
RethinkTHC Research Database. "Atypical Antipsychotic Drugs in Dual Disorders: Current Evid..." RTHC-04045. Retrieved from https://rethinkthc.com/research/martinotti-2022-atypical-antipsychotic-drugs-in
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.