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口服及长效注射用阿立哌唑治疗严重精神疾病与物质使用障碍共病:一项更新的系统评价

Oral and Long-acting Injectable Aripiprazole in Severe Mental Illness and Substance Use Disorder Comorbidity: An Updated Systematic Review.

作者信息

Santorelli Mario, Miuli Andrea, Pettorruso Mauro, Di Carlo Francesco, De Berardis Domenico, Sensi Stefano L, Martinotti Giovanni, Clerici Massimo, di Giannantonio Massimo

机构信息

School of Medicine and Surgery, University of Milano Bicocca, Monza 20900, Italy.

Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy.

出版信息

Curr Neuropharmacol. 2025;23(4):404-411. doi: 10.2174/1570159X23666241023115252.

Abstract

BACKGROUND

Co-occurrence of substance use disorders is frequent in patients with mental health disorders is a condition known as "dual diagnosis". The use of substances worsens the prognosis and lowers the quality of life of psychiatric patients. It also increases the risk of hospitalization and suicide rate.

OBJECTIVES

To assess the effects of aripiprazole therapy on substance use and other psychiatric outcomes in dually diagnosed patients.

METHODS

We performed a systematic review conducted on 3 databases PUBMED, SCOPUS, and Web of Science, selecting original studies and analyzing the impact of aripiprazole therapy on dually diagnosed patients. Six hundred and fifty-five articles were founded and, after removing duplicates (n = 274) and applying the exclusion criteria, 12 articles were included in our systematic review.

RESULTS

12 studies were included, among which 6 were Randomized Controlled Trials. The Most frequent psychiatric diagnosis were schizoaffective disorders, schizophrenia, and bipolar disorders. Alcohol and cocaine use disorders were the most used substances. Eleven studies showed a clinical improvement after aripiprazole treatment. 8 studies evaluated craving and found a significant reduction after treatment with aripiprazole. No definitive conclusions can be drawn on substance usage and maintenance of abstinence.

CONCLUSION

The present findings suggest aripiprazole may be associated with reducing substance craving and improving depression, psychosis, and schizoaffective disorders in dually diagnosed patients.

摘要

背景

物质使用障碍与精神健康障碍在患者中经常同时出现,这是一种被称为“双重诊断”的情况。物质的使用会使精神科患者的预后恶化并降低生活质量。它还会增加住院风险和自杀率。

目的

评估阿立哌唑治疗对双重诊断患者物质使用及其他精神科结局的影响。

方法

我们对3个数据库(PubMed、Scopus和Web of Science)进行了系统评价,选择原始研究并分析阿立哌唑治疗对双重诊断患者的影响。共找到655篇文章,在去除重复项(n = 274)并应用排除标准后,12篇文章被纳入我们的系统评价。

结果

纳入12项研究,其中6项为随机对照试验。最常见的精神科诊断是分裂情感性障碍、精神分裂症和双相情感障碍。酒精和可卡因使用障碍是最常使用的物质。11项研究显示阿立哌唑治疗后有临床改善。8项研究评估了渴求,发现阿立哌唑治疗后渴求显著降低。关于物质使用和戒断维持无法得出明确结论。

结论

目前的研究结果表明,阿立哌唑可能与降低双重诊断患者的物质渴求以及改善抑郁、精神病和分裂情感性障碍有关。

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