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. 2024 Apr 11;13(8):2206.
doi: 10.3390/jcm13082206.

Examining Lurasidone Efficacy in Patients with Schizophrenia Spectrum Illness and Concurrent Alcohol and Substance Use Disorder: A Prospective, Multicentric, Real-World Investigation

Clara Cavallotto  1 , Stefania Chiappini  2 , Alessio Mosca  1 , Giacomo d'Andrea  1 , Francesco Di Carlo  1 , Tommaso Piro  1 , Ottavia Susini  1 , Giulia Stefanelli  1 , Andrea Di Cesare  3 , Valerio Ricci  4 , Maria Pepe  5 , Luigi Dattoli  1 , Marco Di Nicola  5 , Mauro Pettorruso  1 , Giovanni Martinotti  1
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Examining Lurasidone Efficacy in Patients with Schizophrenia Spectrum Illness and Concurrent Alcohol and Substance Use Disorder: A Prospective, Multicentric, Real-World Investigation

Clara Cavallotto et al. J Clin Med. .

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.

Keywords: atypical antipsychotic; dual disorder; schizophrenia spectrum disorder; substance use disorder.

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Conflict of interest statement

G.M. has been a consultant and/or a speaker and/or has received research grants from Angelini, Doc Generici, Janssen-Cilag, Lundbeck, Otsuka, Pfizer, Servier, and Recordati. All the other authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
PANSS, MOAS, and VAS craving scores from baseline to one-month follow-up. * Indicates significant changes with a p-value < 0.05.
Figure 2
Figure 2
Q-LES-Q-SF and SF-36 scores from baseline to one-month follow-up. * Indicates significant changes with a p-value < 0.05.
See this image and copyright information in PMC

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