Moscow Research and Practical Centre on Addictions of the Moscow Department of Healthcare, Moscow, Russia.
Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Moscow, Russia.
J Addict Dis. 2021 Oct-Dec;39(4):513-525. doi: 10.1080/10550887.2021.1905589. Epub 2021 Apr 9.
The article presents the results of a randomized comparative study of Aripiprazole and Quetiapine in the treatment of patients with a dual diagnosis: schizophrenia and substance use disorders. During the study, 90 of the 266 male patients were screened. Among them, 54 individuals (60%) had a previously established diagnosis of mental disorder and 36 patients (40%) had no established psychiatric diagnosis. They were randomly randomized into three groups of 30 patients, each receiving an antipsychotic: Aripiprazole at a dose of up to 20 mg daily, Quetiapine at a dose of up to 600 mg daily, or Haloperidol at a dose of up to 30 mg daily. The efficacy of Aripiprazole and Quetiapine was evaluated using the following scales: PANSS, BPRS, VAS, and Substance Craving Scale (SCS). Drug safety was assessed by the development of adverse events, serious adverse events, or adverse reactions. Study results demonstrated the efficacy of atypical antipsychotics in the three groups. Analysis of independent variables showed significant differences between Aripiprazole and Haloperidol in PANSS and BPRS scores by Visit 4, in VAS scores by Visit 3, and in SCS scores by Visit 2. Intergroup analysis of independent variables showed significant differences between Quetiapine and Haloperidol in PANSS, VAS, and SCS scores by Visit 4. Intergroup analysis of independent variables showed significant differences between Aripiprazole and Quetiapine in the VAS and SCS scores. The correlation analysis allowed drawing conclusions about the close connection of the symptoms of schizophrenia and substance use disorders in patients with a dual diagnosis.
本文呈现了一项阿立哌唑和喹硫平治疗双重诊断(精神分裂症和物质使用障碍)患者的随机对照研究结果。在研究过程中,对 266 名男性患者进行了筛选,其中 54 名(60%)患者有明确的精神障碍诊断,36 名(40%)患者没有明确的精神科诊断。他们被随机分为三组,每组 30 名患者,分别接受以下抗精神病药物治疗:阿立哌唑,最高剂量达 20mg/日;喹硫平,最高剂量达 600mg/日;氟哌啶醇,最高剂量达 30mg/日。使用 PANSS、BPRS、VAS 和物质渴求量表(SCS)评估阿立哌唑和喹硫平的疗效。通过不良事件、严重不良事件或不良反应的发生评估药物安全性。研究结果显示,三组中的非典型抗精神病药物均具有疗效。对自变量进行分析显示,阿立哌唑与氟哌啶醇在第 4 次访视时的 PANSS 和 BPRS 评分、第 3 次访视时的 VAS 评分、第 2 次访视时的 SCS 评分方面存在显著差异;喹硫平与氟哌啶醇在第 4 次访视时的 PANSS、VAS 和 SCS 评分方面存在显著差异;阿立哌唑与喹硫平在 VAS 和 SCS 评分方面存在显著差异。对自变量进行相关性分析后得出结论,双重诊断患者的精神分裂症症状与物质使用障碍密切相关。