Atypical antipsychotics in the treatment of subjects with schizophrenia and substance abuse disorders

Substance use disorders (SUDs) are present in more than 50% of subjects diagnosed with schizophrenia. It is considered that substance abuse hastens the onset of schizophrenia, worsens its symptoms, leads to poorer therapeutic compliance and increases hospitalizations In thispopulation. However, there are no controlled studies assessing the effectiveness of antipsychotic drugs in this subgroup of patients. In this paper we review consequences of SUDs in subjects with schizophrenia and factors involved in therapeutic adherence to treatment. Results from two risperidone versus zuclophentixol controlled trials were included. Risperidone and long-acting injectable risperidone were more effective than zuclopenthixol-depot in improving substance abuse and symptoms of schizophrenia in subjects with dual diagnosis. Atypical antipsychotics could be the best pharmacological strategy in the treatment of subjects with schizophrenia and substance abuse comorbidity.