Skip Navigation


Schizophrenia Bulletin Advance Access originally published online on August 3, 2006
Schizophrenia Bulletin 2006 32(4):644-654; doi:10.1093/schbul/sbl010
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
32/4/644    most recent
sbl010v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Petrakis, I. L.
Right arrow Articles by Ralevski, E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Petrakis, I. L.
Right arrow Articles by Ralevski, E.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author 2006. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org.

Psychotic Spectrum Disorders and Alcohol Abuse: A Review of Pharmacotherapeutic Strategies and a Report on the Effectiveness of Naltrexone and Disulfiram

Ismene L. Petrakis1, Charla Nich and Elizabeth Ralevski
Department of Psychiatry, Yale University School of Medicine, VA Connecticut Healthcare System, 950 Campbell Avenue, Mail Code 116A, West Haven, CT 06516

1To whom correspondence should be addressed; tel: 203-932-5711 ext. 2244, fax: 203-937-4791, e-mail: ismene.petrakis{at}yale.edu.

The rate of substance-use disorders in patients with mental illnesses within the psychotic spectrum, such as schizophrenia, schizoaffective disorder, and bipolar disorder, is higher than the rate observed in the general population and is associated with significant morbidity and mortality. Although there are currently 3 medications approved by the Food and Drug Administration for the treatment of alcohol dependence, no medications have been approved for the specific treatment of dually diagnosed patients. A small but growing body of literature supports the use of 2 of these medications, disulfiram and naltrexone, in dually diagnosed individuals. This article outlines a review of the literature about the use of disulfiram and naltrexone for alcoholism and in patients with comorbid mental illness. In addition, results are presented of a 12-week randomized clinical trial of disulfiram and naltrexone alone and in combination for individuals with Axis I disorders and alcohol dependence who were also receiving intensive psychosocial treatment. Individuals with a psychotic spectrum disorder, including schizophrenia, schizoaffective disorder, and bipolar disorder, had worse alcohol outcomes than those without a psychotic spectrum disorder. Individuals with a psychotic spectrum disorder had better alcohol-use outcomes on an active medication compared with placebo, but there was no clear advantage of disulfiram or naltrexone or of the combination. Retention rates and medication compliance in the study were high and exceeded 80%. Pharmacotherapeutic strategies should take into account the advantages and disadvantages of each medication. Future directions of pharmacotherapeutic options are also discussed.

Keywords: psychosis / alcoholism / naltrexone / disulfiram / comorbidity / pharmacotherapy


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Am. J. PsychiatryHome page
A. I. Green, R. E. Drake, M. F. Brunette, and D. L. Noordsy
Schizophrenia and Co-Occurring Substance Use Disorder
Am J Psychiatry, March 1, 2007; 164(3): 402 - 408.
[Full Text] [PDF]

Home page
 FocusHome page
M. L. Verduin
Ask the Expert: Treatment Strategy for Co-occurring Bipolar Disorder and Alcohol Abuse
Focus, January 1, 2007; 5(2): 170 - 171.
[Full Text] [PDF]


Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.