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Observational Study on Medications Prescribed to Dual-Diagnosis Outpatients

Grau-López, Lara MD; Roncero, Carlos PhD; Daigre, Constanza MS; Miquel, Laia MD; Barral, Carmen MD; Gonzalvo, Begoña MD; Collazos, Francisco MD; Casas, Miquel PhD

doi: 10.1097/ADM.0000000000000024
Original Research

Objectives: To quantify the number of medications used for treating psychiatric and addictive disorders in a cohort of dual diagnosis with substance dependence outpatients and report the most frequent pharmacological groups used.

Methods: A descriptive, cross-sectional study was conducted. Demographic data, Axis I comorbidity diagnosis with substance dependence, and the medications prescribed were recorded. Diagnosis was assessed by the Structured Clinical Interview for DSM-IV (SCID).

Results: One hundred seven patients (mean age 37.7 years; SD = 10.2 years) were evaluated (76.6% men). On average, patients took 4.0 (SD = 1.8) medications. The pharmacological groups prescribed were antipsychotics (69.2%) followed by antidepressants (65.4%), antiepileptics (58.9%), anxiolytics (37.4%), alcohol-aversive drugs (15.9%), methadone (15.9%), lithium (3.7%), and naltrexone (2.8%). Older patients (>45 years old) were found to have a higher number of prescribed medications. Patients diagnosed with a dual psychotic disorder were prescribed a larger number of pharmacological agents (mean = 4.4; SD = 2.1) than patients with a mood disorder (mean = 3.7; SD = 1.3) or an anxiety disorder (mean = 2.9; SD = 1.2), K = 10.5, P = 0.005.

Conclusions: Because polypharmacy is frequent in patients with mental illness and a co-occurring substance use disorder, specialized approaches need to be developed.

From the Outpatient drug clinic (CAS) Vall d'Hebron (LGL, CR, CD, LM, CB, BG), Department of Psychiatry, Vall Hebron University Hospital, Public Health Agency of Barcelona (ASPB), Barcelona, Spain; Department of Psychiatry (LGL, CR, LM, CB, FC, MC), Vall Hebron University Hospital, Autonomous University of Barcelona, CIBERSAM, Barcelona, Spain; and Department of Psychiatry and Forensic Medicine (LGL, CD, CR, FC, MC), Autonomous University of Barcelona, Barcelona, Spain.

Send correspondence and reprint requests to Lara Grau-López, MD, Department of Psychiatry, Vall Hebron University Hospital, Paseo de Vall Hebron 119-129, 08035. Barcelona. Spain. E-mail:

The authors declare that they have no competing interests.

Received November 12, 2012

Accepted January 04, 2014

© 2014 American Society of Addiction Medicine