Clozapine or antipsychotic polytherapy appear to be the best approach in reducing the risk for a SUD in adults with schizophrenia.
Research on the effectiveness of pharmacotherapies for schizophrenia and comorbid SUD is"very sparse, and more importantly, non-existent on the prevention of the development of SUDs in patients with schizophrenia," the researchers note.
In patients with schizophrenia without SUD, treatment with clozapine was associated with lowest risk for an initial SUD in both Finland and Sweden , compared with no use or use of other antipsychotics.was associated with the second lowest risk for an initial SUD and antipsychotic polytherapy the third lowest risk .
"A similar potential bias exists for long-acting injectables , as these have generally also been used late in the treatment algorithm," he noted. "Why antipsychotic polytherapy came out as the second-best treatment is much less clear. Clearly head-to-head randomized trials are needed to follow up on these interesting an intriguing naturalistic database study data," said Correll.
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