Возможности рациональной терапии антипсихотиками пациентов с шизофренией и коморбидной зависимостью от психоактивных веществ

Обоснование: злоупотребление психоактивными веществами (ПАВ) широко распространено среди пациентов, страдающих шизофренией. Выбор тактики лечения пациента с двойным диагнозом представляет значительные трудности для клинициста за счет особенностей взаимовлияния двух заболеваний, худшей переносимости психофармакотерапии, низкого комплаенса. Цель исследования: проанализировать данные литературы, посвященной патогенезу развития коморбидных расстройств вследствие употребления ПАВ у пациентов, страдающих шизофренией, и современным стратегиям их лечения антипсихотиками с кратким обзором механизмов сочетанного действия препаратов. Материалы и методы: по ключевым сло вам «шизофрения», «зависимость от алкоголя», «коморбидность» «антипсихотическая терапия», “schizophrenia”, “alcohol use disorder”, “SUD”, “comorbidity”, “antipsychotic drugs” проведен поиск научных публикаций в базах Google Scholar, ELibrary.ru, Scopus, PubMed и составлен нарративный обзор литературы. Заключение: существуют различные теории, призванные объяснить механизм формирования коморбидной зависимости у пациентов, страдающих шизофренией. Современные исследования предполагают нейробиологическую общность этих расстройств, что и определяет терапевтическую стратегию в отношении данной группы больных. Анализ научных публикаций позволяет сделать вывод о перспективности применения эффективности антипсихотиков 3-го поколения в лечении коморбидных расстройств, что может стать объектом дальнейших клинических исследований.

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