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Clozapine, quetiapine and olanzapine among addicted schizophrenic patients: towards testable hypotheses.
- Source :
-
International clinical psychopharmacology [Int Clin Psychopharmacol] 2003 May; Vol. 18 (3), pp. 121-32. - Publication Year :
- 2003
-
Abstract
- Although life prevalence of substance use disorders among patients with schizophrenia is close to 50%, few studies have been carried out to date to identify an integrated pharmacological treatment for this comorbidity. So far, the most promising results, that we report here, have been obtained with clozapine. To a lesser extent, quetiapine and olanzapine, both clozapine analogues, have also shown promising results. Further to these observations, the present paper critically reviews the advantages associated with clozapine, quetiapine and olanzapine, and their relevance to the treatment of addiction among schizophrenic patients. Six characteristics seem to distinguish clozapine, quetiapine and olanzapine from the first-generation antipsychotics: (1) acting preferentially on the reward system, these second-generation antipsychotics (mainly clozapine and quetiapine) induce almost no extrapyramidal symptoms; (2) quickly dissociating from D(2), theses drugs (mainly clozapine and quetiapine) seem not to induce dysphoria, unlike conventional antipsychotics like haloperidol;(3) these drugs (mainly clozapine) seem more effective in the treatment of negative symptoms than conventional antipsychotics; (4) because of a diversified activity on several serotoninergic and noradrenergic receptors, these drugs positively alter mood, which does not seem to be the case with conventional antipsychotics, except for flupenthixol; (5) these drugs have a positive impact on cognition, which is not the case with the first-generation antipsychotics; (6) unlike conventional antipsychotics, these drugs seem to have a moderate affinity for 5-HT(3), the receptor on which ondansetron, an anti-craving medication, acts.
- Subjects :
- Affect
Antipsychotic Agents administration & dosage
Basal Ganglia Diseases chemically induced
Benzodiazepines
Clozapine administration & dosage
Cognition
Comorbidity
Dibenzothiazepines administration & dosage
Drug Therapy, Combination
Humans
Olanzapine
Pirenzepine administration & dosage
Quetiapine Fumarate
Receptors, Serotonin drug effects
Receptors, Serotonin, 5-HT3
Substance-Related Disorders psychology
Treatment Outcome
Antipsychotic Agents pharmacology
Clozapine pharmacology
Dibenzothiazepines pharmacology
Pirenzepine analogs & derivatives
Pirenzepine pharmacology
Schizophrenia complications
Schizophrenia drug therapy
Substance-Related Disorders drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 0268-1315
- Volume :
- 18
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- International clinical psychopharmacology
- Publication Type :
- Academic Journal
- Accession number :
- 12702890
- Full Text :
- https://doi.org/10.1097/01.yic.0000063501.97247.38