Neyra, AdriánParro Torres, CarlosRos-Cucurull, ElenaCarrera, IndalecioEcharri, EduardoTorrens, Marta2025-02-032025-02-032024Neyra A, Parro-Torres C, Ros-Cucurull E, Carrera I, Echarri E, Torrens M. Management of schizophrenia and comorbid substance use disorders: expert review and guidance. Ann Gen Psychiatry. 2024 Oct 30;23(1):40. DOI: 10.1186/s12991-024-00529-71744-859Xhttp://hdl.handle.net/10230/69456Background: Schizophrenia and substance use disorders (SUDs) are often comorbid conditions that present clinical challenges due to their heterogeneity and the difficulties associated with poor physical health, low medication adherence, high relapse and hospitalization rates, and increased risk of mortality. This is often exacerbated by a fragmented health care system that treats addiction and mental illness separately, leading to delays in proper diagnosis and treatment. Main text: The aim of this narrative review, based on an extensive literature search and experts' clinical experience, is to synthesize evidence on the psychopathological and clinical characteristics of patients, the burden and management at the level of healthcare system, and possible gaps in the treatment of schizophrenia with comorbid SUD in order to understand and address the needs of patients. Treatment options, differences between antipsychotic medications, and the benefits of long-acting formulations and partial dopaminergic agonists are described. Partial dopamine agonists (aripiprazole, cariprazine, and brexpiprazole) have demonstrated good control of psychotic symptoms and SUDs with a favorable safety profile. Conclusion: Pharmacological interventions should be accompanied by psychosocial support within an integrated and multidisciplinary approach that promotes shared decision-making and a good therapeutic alliance between the entire medical team and the patient.application/pdfeng© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you wiinfo:eu-repo/semantics/articlehttp://dx.doi.org/10.1186/s12991-024-00529-7AntipsychoticsCare managementComorbid disordersDual diagnosisSchizophreniaSubstance use disorderinfo:eu-repo/semantics/openAccess