Şizofrenide alkol madde kullanım bozuklukları eştanısı

Şizofreni tanısı alan hastalarda alkol ve madde kullanımı yaygındır. Şizofrenide alkol madde kullanım bozuklukları sıklığı yüksek olmasına rağmen yapılantüm çalışmalarda madde kullanım ektanısının dışlanması bu alandaki verilerinçok kısıtlı olmasına yol açmıştır. Yüksek eştanılılığın açıklanmasında pek çokteori öne atılmıştır. Tipik antipsikotik ilaçların şizofreni tanılı hastalarda alkolve madde kullanımına etkileri sınırlıdır. Atipik antipsikotik ilaçların özellikleklozapin kullanımının etkinliği gösterilmiştir. Literatüre baktığımızda, alkolkötüye kullanımı tedavisinde pek çok yeni ajan ortaya çıkmışsa da, sadece birtanesinin (naltrekson) şizofreni tanılı hastalarda kullanımına dair çalışmalarmevcuttur. Bu hasta populasyonunda, farmakolojik yaklaşımların tek başınaen uygun fayda getireceğini düşünmek doğru bir yaklaşım olmaz. Psikoterapinin de içerisinde bulunduğu, iyi koordine edilmiş bir tedavi planı mutlakhedef olmalıdır.

Substance use disorders comorbidity in schizophrenia

U se of alcohol and other substances are commonly observed among patientswith a diagnosis of schizophrenia. Despite this common comorbidity, therehave been very few studies which do not take alco hol/substance use as anexclusion criterion. Thus we have very limited data on this specific area. Anumber of theories have been developed to explain these high comorbidityrates. Typical antipsychotic medications decreases alcohol or substance use ingeneral, but this is valid only for a limited extend in patients with schizophre-nia. On the other hand atypical antipsychotics, particularly clozapine plays anactive role in that respect. Recently, we can see lots of new adjunctive medications formulated for the treatment of alcoholism, but only one of them (naltrexone) has thus far been carefully studied and tested in relation with these patients with schizo phrenia. It is not reasonable to consider that pharmacological approaches may alone provide us with optimal results in these patientUltimately, it should be intended to have a well-balanced psychosocial treament programs including also psychotherapetic al inputs.

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