Many schizophrenic patients, who are treated by second-generation antipsychotic drugs, do not adhere to the pharmacotherapy and consume substances such as nicotine and alcohol or drugs such as cannabis and amphetamines.
‘Substance abuse when combined with antipsychotic medications could worsen the outcome of schizophrenia’
Nicotine activates dopaminergic neurons, and alcohol increases dopamine release. These substances and drugs can worsen psychotic symptoms. We aimed to show measures to reduce substance and drug abuse and to increase patients' adherence to the pharmacological treatment.
Consuming such substances and drugs and the non-adherence to the pharmacotherapy worsens the outcome of the disease.
On the one hand, the administration of long-acting injectable antipsychotic drugs increases the adherence to the pharmacotherapy. On the other hand, psychoeducation can enable to reduce substances and drugs abuse.
Cannabis has two compounds, namely tetrahydrocannabidiol (THC), which is psychotomimetic, and cannabidiol (CBD), which has antipsychotic properties. CBD can reduce psychotic symptoms. Vancreline, a nicotinergic cholinergic agonist, can enable to reduce smoking.