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Comorbid Schizophrenia and Substance Abuse

Alan I. Green and E. Sherwood Brown

Published: September 15, 2006

Article Abstract

At some point during their lives, manypatients with schizophrenia abuse substances. The co-occurrence of substanceuse leads to poorer long- and short-term outcomes in schizophrenia andcomplicates the treatment of both conditions. The primary substances of abuseamong schizophrenia patients are alcohol, cannabis, cocaine, and nicotine. Thispresentation describes the prevalence, outcomes, and basis for this comorbidity.A brief discussion about the neurobiology of schizophrenia explains howschizophrenia may create a biologic predisposition to substance abuse byaltering the brain reward system. The efficacy of possible treatments forcomorbid schizophrenia and substance abuse are weighed, including typical andatypical antipsychotics and psychosocial interventions, and a list of possibleadjunctive agents is provided.

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