University of Salamanca Healthcare Complex, Department of Psychiatry, Salamanca, Spain; University of Salamanca, Institute of Biomedicine of Salamanca, Salamanca, Spain.
Autonomous University of Barcelona, Department of Psychiatry, Barcelona, Spain.
Psychiatry Res. 2020 Feb;284:112660. doi: 10.1016/j.psychres.2019.112660. Epub 2019 Oct 28.
Patients diagnosed with schizophrenia are at least three times more likely to develop a substance use disorder than controls. These patients are frequently prescribed benzodiacepines as a coadjuvant drug, which have a high potential for addiction. We performed a literature review aiming to gather evidence on various topics concerning the use of benzodiacepines in schizophrenia, with a focus on possible abuse: 1) Prevalence of prescripted and non-prescripted benzodiacepine use among patients, 2) Prevalence of abusers, 3) Effects of long-term benzodiacepine abuse in schizophrenia prognosis, 4) Possible management strategies for benzodiacepine abuse in this population. Our search revealed there is a high variability (up to 20%) in benzodiacepine abuse among patients, with cannabis and stimulants being more frequent, and no clear demographic traits have been identified among these patients. Patients with affective symptoms are more likely to abuse benzodiazepines. Its long-term effects on prognosis have been debated, with some papers hinting at a higher mortality rate. Tapering benzodiacepines has been associated with an improvement in some cognitive functions. Management strategies for potential abuse do not differ greatly for this population, and no specific pharmacological aid can be indicated, but an integral approach is proposed.
被诊断为精神分裂症的患者比对照组患者更容易出现物质使用障碍，其可能性至少高出三倍。这些患者经常被开苯二氮䓬类药物作为辅助药物，这些药物有很高的成瘾性。我们进行了文献综述，旨在收集有关苯二氮䓬类药物在精神分裂症中使用的各种主题的证据，重点关注可能的滥用问题：1）患者中处方和非处方苯二氮䓬类药物的使用情况；2）滥用者的比例；3）长期滥用苯二氮䓬类药物对精神分裂症预后的影响；4）针对该人群中苯二氮䓬类药物滥用的可能管理策略。我们的研究结果表明，患者中苯二氮䓬类药物滥用的比例存在很大的差异（高达 20%），其中大麻和兴奋剂更为常见，而且这些患者中没有明确的人口统计学特征。伴有情感症状的患者更有可能滥用苯二氮䓬类药物。其对预后的长期影响存在争议，一些研究表明死亡率更高。逐渐减少苯二氮䓬类药物的使用与一些认知功能的改善有关。针对潜在滥用的管理策略在该人群中并没有太大区别，也没有特定的药物可以辅助，但提出了一种综合方法。
