Volume 29, Issue 163, September 2025

Psychopharmacological interventions for co-occurring substance use and mental health disorders: a comprehensive review

Paweł Czyż^1♦, Marta Górska², Jakub Górski³, Maciej Janowski², Antonina Strzałkowska²

¹Municipal Hospital of St.Vincent de Paul in Gdynia, ul. Wójta Radtkego 18, 81-348 Gdynia, Poland
²Central Teaching Hospital of Medical University of Lodz, Pomorska 251, 92-213 Lodz, Poland
³Medical University of Lodz, Pomorska 251; 92-213 Lodz, Poland

^♦Corresponding author
Paweł Czyż, Municipal Hospital of St.Vincent de Paul in Gdynia, Gdynia, Poland

ABSTRACT

The co-occurrence of mental disorders and a substance use disorder, referred to as dual diagnosis, is perhaps the most clinically demanding condition because both disorders mutually exacerbate each other. This systematic review encompasses psychopharmacologic therapy in this patient population. We utilized major electronic databases and recent 10-year publications, as well as research published in English, Spanish, Polish, German, and Italian. Second-generation antipsychotics are the first-line treatment for comorbid psychosis with improved tolerability despite metabolic side effects. SSRIs and SNRIs are first-line therapy for depression, but the optimal timing of their initiation is controversial. Mood stabilizers like anticonvulsants are very important in bipolar disorder but require careful monitoring due to unique adherence and drug level concerns. We are also cautious with anti-anxiety medication because they are high-risk for abuse. The review shows that medication is not enough on its own. We combine it with social support and EBM therapies. There are still significant areas for future research, including the need for more long-term studies and the development of new medications that target standard neurobiological processes.

Keywords: addiction, psychotropic medications, dual diagnosis, comorbidity, pharmacological therapy

Medical Science, 2025, 29, e163ms3703

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DOI: https://doi.org/10.54905/disssi.v29i163.e163ms3703

Published: 14 September 2025