Addiction Disorders and Psychiatric Cormorbidity

Question 1

Why are illicit drugs often used as a form of self medications?

Answer 1

Their mechanism of action is very similar to the drugs used as psychotherapeutic agents

Question 2

Describe how drug use might actually make one more susceptible to mental illness.

Answer 2

chronic drug use can alter brain receptors such that one is more susceptible

Question 3

Why is there often diagnostic confusion between mental illness and drug use?

Answer 3

because both intoxication and withdrawal can resemble symptoms of many psychiatric disorders

Question 4

What is a key thing to ask when trying to figure out the causal connection between drug use and mental illness?

Answer 4

ask which symptoms began first and whether the symptoms persist during sustained periods of abstinence

Question 5

Why should you delay treatment by a few weeks for mental illness/sustance abuse if possible?

Answer 5

stopping the substance use and waiting allows for identification of transient substance-induced symptoms

Question 6

What happened in the study that gave sertraline to depressed individuals on methadone?

Answer 6

it indirectly improved their opioid addiction

Question 7

When are benzodizepines most helpful in terms of mental illness/drug abuse.

Answer 7

basically just use during acute detox - long term is controversial

Question 8

Is it the antidepressant that directly helps the SUD, or just the decrease in depressive symptoms?

Answer 8

it’s more likely the decrease in depressive symptoms

Question 9

In bipolar disorder with SUD, what is most effective? Lithium, Depakote, Tegretol, therapy, or combo?

Answer 9

combo

Question 10

What percentage of individuals with schizophrenia also have an SUD>

Answer 10

50% - alcohol most common

Question 11

What drug was given to help people wtih schizophrenia decrease their alcohol dependence?

Answer 11

naltrexone

Question 12

True or false: SSRIs for anxiety disorders also help SUD?

Answer 12

false

Question 13

Which usually comes first, SUD or social aniety disorder?

Answer 13

social anxiety disorder

Question 14

PTSD and SUD are divided into three clusters that vary in terms of which symptoms started first. Which cluster benefits most from treatment with sertraline?

Answer 14

cluster 3 - the peopl who have early onset severe alcoholismand later-onset PTSD

Question 15

In treating ADHD and comorbid SUD, what drug class should you avoid?

Answer 15

psychostimulants unfortunately - so use buprorion or tricyclics