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Cavallotto C, Chiappini S, Mosca A, d’Andrea G, Di Carlo F, Piro T, Susini O, Stefanelli G, Di Cesare A, Ricci V, Pepe M, Dattoli L, Di Nicola M, Pettorruso M, Martinotti G. Examining Lurasidone Efficacy in Patients with Schizophrenia Spectrum Illness and Concurrent Alcohol and Substance Use Disorder: A Prospective, Multicentric, Real-World Investigation. J Clin Med 2024; 13:2206. [PMID: 38673478 PMCID: PMC11051375 DOI: 10.3390/jcm13082206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/18/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Dual disorders (DD) entail the coexistence of a substance use disorder (SUD) and another mental health condition, often within psychotic and affective disorders. This study aims to evaluate lurasidone, an innovative atypical antipsychotic, in individuals diagnosed with schizophrenia spectrum disorder and concurrent comorbidities of alcohol use disorder/substance use disorder (AUD/SUD). Methods: A cohort of 23 subjects diagnosed with schizophrenia spectrum disorder and comorbid AUD/SUD underwent psychometric assessments at baseline (T0) and one-month (T1) post-lurasidone initiation. Results: Lurasidone exhibited significant reductions in psychopathological burden, evidenced by decreased total PANSS scores (Z = 2.574, p = 0.011). Positive symptoms, substance craving (VAS Craving; Z = 3.202, p = 0.001), and aggressivity (MOAS scale; Z = 2.000, p = 0.050) were notably reduced. Clinical Global Impression (CGI) scores significantly improved (Z = 2.934, p = 0.003). Quality of life enhancements were observed in SF-36 subscales (energy, emotional well-being, and social functioning) (p < 0.05) and Q-LES-Q-SF scale (Z = -2.341, p = 0.021). A safety analysis indicated lurasidone's good tolerability, with only 8.7% reporting discontinuation due to side effects. Conclusions: This study offers initial evidence supporting lurasidone's efficacy and safety in dual diagnoses, highlighting positive effects on psychopathology, substance craving, and quality of life. These findings emphasize the need for tailored, comprehensive treatment strategies in managing the complexities of this patient population.
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Affiliation(s)
- Clara Cavallotto
- Department of Neurosciences, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy; (C.C.); (G.d.); (F.D.C.); (T.P.); (G.S.); (L.D.); (M.P.)
| | - Stefania Chiappini
- School of Medicine, UniCamillus International Medical School University, 00131 Rome, Italy;
| | - Alessio Mosca
- Department of Neurosciences, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy; (C.C.); (G.d.); (F.D.C.); (T.P.); (G.S.); (L.D.); (M.P.)
| | - Giacomo d’Andrea
- Department of Neurosciences, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy; (C.C.); (G.d.); (F.D.C.); (T.P.); (G.S.); (L.D.); (M.P.)
| | - Francesco Di Carlo
- Department of Neurosciences, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy; (C.C.); (G.d.); (F.D.C.); (T.P.); (G.S.); (L.D.); (M.P.)
| | - Tommaso Piro
- Department of Neurosciences, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy; (C.C.); (G.d.); (F.D.C.); (T.P.); (G.S.); (L.D.); (M.P.)
| | - Ottavia Susini
- Department of Neurosciences, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy; (C.C.); (G.d.); (F.D.C.); (T.P.); (G.S.); (L.D.); (M.P.)
| | - Giulia Stefanelli
- Department of Neurosciences, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy; (C.C.); (G.d.); (F.D.C.); (T.P.); (G.S.); (L.D.); (M.P.)
| | - Andrea Di Cesare
- Department of Mental Health, ASL 02 Lanciano-Vasto-Chieti, 66100 Chieti, Italy;
| | - Valerio Ricci
- Department of Psychiatry, “San Luigi Gonzaga” Hospital, University of Turin, 10124 Turin, Italy
| | - Maria Pepe
- University Policlinic Foundation “A. Gemelli” IRCSS-Catholic University of the Sacred Heart, Largo Agostino Gemelli, 8, 00136 Rome, Italy (M.D.N.)
| | - Luigi Dattoli
- Department of Neurosciences, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy; (C.C.); (G.d.); (F.D.C.); (T.P.); (G.S.); (L.D.); (M.P.)
| | - Marco Di Nicola
- University Policlinic Foundation “A. Gemelli” IRCSS-Catholic University of the Sacred Heart, Largo Agostino Gemelli, 8, 00136 Rome, Italy (M.D.N.)
| | - Mauro Pettorruso
- Department of Neurosciences, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy; (C.C.); (G.d.); (F.D.C.); (T.P.); (G.S.); (L.D.); (M.P.)
| | - Giovanni Martinotti
- Department of Neurosciences, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy; (C.C.); (G.d.); (F.D.C.); (T.P.); (G.S.); (L.D.); (M.P.)
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Ricci V, De Berardis D, Maina G. Third-Generation Antipsychotics and Lurasidone in the Treatment of Substance-Induced Psychoses: A Narrative Review. Healthcare (Basel) 2024; 12:339. [PMID: 38338224 PMCID: PMC10855531 DOI: 10.3390/healthcare12030339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/09/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
This narrative review explores the efficacy and tolerability of third-generation antipsychotics (TGAs)-aripiprazole, cariprazine, brexpiprazole, and lurasidone-for the management of substance-induced psychosis (SIP). SIP is a psychiatric condition triggered by substance misuse or withdrawal, characterized by unique features distinct from those of primary psychotic disorders. These distinctive features include a heightened prevalence of positive symptoms, such as hallucinations and delusions, in addition to a spectrum of mood and cognitive disturbances. This review comprehensively investigates various substances, such as cannabinoids, cocaine, amphetamines, and LSD, which exhibit a greater propensity for inducing psychosis. TGAs exhibit substantial promise in addressing both psychotic symptoms and issues related to substance misuse. This review elucidates the distinctive pharmacological properties of each TGA, their intricate interactions with neurotransmitters, and their potential utility in the treatment of SIP. We advocate for further research to delineate the long-term effects of TGAs in this context and underscore the necessity for adopting an integrated approach that combines pharmacological and psychological interventions. Our findings underscore the intricate and multifaceted nature of treating SIP, highlighting the potential role of TGAs within therapeutic strategies.
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Affiliation(s)
- Valerio Ricci
- San Luigi Gonzaga Hospital, University of Turin, Regione Gonzole 10, 10043 Orbassano, Italy;
| | - Domenico De Berardis
- NHS, Department of Mental Health, Psychiatric Service for Diagnosis and Treatment, Hospital “G. Mazzini”, ASL 4, 64100 Teramo, Italy;
| | - Giuseppe Maina
- San Luigi Gonzaga Hospital, University of Turin, Regione Gonzole 10, 10043 Orbassano, Italy;
- Department of Neurosciences “Rita Levi Montalcini”, University of Turin, 10124 Torino, Italy
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