Ricci Valerio, De Berardis Domenico, Maina Giuseppe
San Luigi Gonzaga Hospital, University of Turin, Regione Gonzole 10, 10043 Orbassano, Italy.
NHS, Department of Mental Health, Psychiatric Service for Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, 64100 Teramo, Italy.
Healthcare (Basel). 2024 Jan 29;12(3):339. doi: 10.3390/healthcare12030339.
This narrative review explores the efficacy and tolerability of third-generation antipsychotics (TGAs)-aripiprazole, cariprazine, brexpiprazole, and lurasidone-for the management of substance-induced psychosis (SIP). SIP is a psychiatric condition triggered by substance misuse or withdrawal, characterized by unique features distinct from those of primary psychotic disorders. These distinctive features include a heightened prevalence of positive symptoms, such as hallucinations and delusions, in addition to a spectrum of mood and cognitive disturbances. This review comprehensively investigates various substances, such as cannabinoids, cocaine, amphetamines, and LSD, which exhibit a greater propensity for inducing psychosis. TGAs exhibit substantial promise in addressing both psychotic symptoms and issues related to substance misuse. This review elucidates the distinctive pharmacological properties of each TGA, their intricate interactions with neurotransmitters, and their potential utility in the treatment of SIP. We advocate for further research to delineate the long-term effects of TGAs in this context and underscore the necessity for adopting an integrated approach that combines pharmacological and psychological interventions. Our findings underscore the intricate and multifaceted nature of treating SIP, highlighting the potential role of TGAs within therapeutic strategies.
本叙述性综述探讨了第三代抗精神病药物(TGA)——阿立哌唑、卡立哌嗪、布雷哌唑和鲁拉西酮——用于治疗物质所致精神病(SIP)的疗效和耐受性。SIP是一种由物质滥用或戒断引发的精神疾病,具有与原发性精神障碍不同的独特特征。这些独特特征包括除一系列情绪和认知障碍外,幻觉和妄想等阳性症状的患病率较高。本综述全面研究了大麻素、可卡因、苯丙胺和麦角酸二乙酰胺等各种更易诱发精神病的物质。TGA在解决精神病症状和与物质滥用相关问题方面显示出巨大前景。本综述阐明了每种TGA的独特药理特性、它们与神经递质的复杂相互作用以及它们在治疗SIP中的潜在效用。我们主张进一步研究以明确TGA在此背景下的长期影响,并强调采用结合药物和心理干预的综合方法的必要性。我们的研究结果强调了治疗SIP的复杂性和多面性,突出了TGA在治疗策略中的潜在作用。