Pharmacotherapy in dual diagnosis

Ilana Crome is Professor of Addiction Psychiatry and Academic Director of Psychiatry, Keele University Medical School (Academic Psychiatry Unit, Keele University Medical School (Harplands Campus), Hilton Road, Harpfields, Stoke on Trent ST4 6TH, UK. E-mail: pca03{at}keele.ac.uk), and a consultant in addiction for North Staffordshire Combined Healthcare NHS Trust. Since the 1980s she has been directly and actively involved in national clinical research, training and policy developments in the dual diagnosis field both nationally and internationally. At the time of writing this article Tracey Myton was a specialist registrar in addiction psychiatry with Alcohol and Drugs North West, part of Bolton, Salford and Manchester Mental Health Trust. Her special interests are dual diagnosis, young people and treating substance misusers, particularly women, in the prison setting. She intends to become a consultant in addiction psychiatry.

The prevalence of coexisting substance misuse and psychiatric disorder (dual diagnosis, comorbidity) has increased over the past decade, and the indications are that it will continue to rise. There have simultaneously been unprecedented developments in the pharmacological treatment of alcohol, opiate and nicotine misuse. Here we evaluate the evidence on the use of some of these treatments in dual diagnosis (with psychotic, mood and anxiety disorders). The evidence base is limited by the exclusion of mental illness when pharmacological agents for substance misuse are evaluated and vice versa. We set the available information within the context of the psychosocial management of comorbid substance misuse and mental illness, and the framework for service delivery recommended by UK national policy.

This article has been cited by other articles:

				J. Withecomb Young people and consent to treatment Adv. Psychiatr. Treat., March 1, 2005; 11(2): 157 - 157. [Full Text] [PDF]

eLetters: