The Possibilities of Rational Antipsychotic Therapy in Patients with Schizophrenia and Comorbid Substance Dependence

Background : substance abuse disorder is widespread among schizophrenic patients. The choice of treatment strategy for a patient with a dual diagnosis presents significant difficulties for the clinician due to the peculiarities of the mutual influence of the two diseases, worse tolerance of psychopharmacotherapy, and low compliance. The aim of review was to analyze the scientific publications on the pathogenesis of comorbid substance use disorders in schizophrenic patients and current strategies of their treatment with antipsychotics considering drug interactions. Materials and Methods : a narrative review of scientific publications was compiled using available sources in the literature, including a search using combinations of keywords «шизофрения», «зависимость от алкоголя», «коморбидность» «антипсихотическая терапия», “schizophrenia”, “alcohol use disorder”, “SUD”, “comorbidity”, “antipsychotic drugs” in Google Scholar, ELibrary.ru, Scopus, PubMed databases. Conclusion : there are various theories designed to explain the mechanism of comorbid addiction formation in patients suffering from schizophrenia. One way or another at present, the common neurobiological basis of these disorders is no doubt, that determines the therapeutic strategy for this group of patients. The available publications shows promising prospects for the effectiveness of 3rd generation antipsychotics in the treatment of comorbid disorders, but further researches are needed.