Evolution of substance use, neurological and psychiatric symptoms in schizophrenia and substance use disorder patients: A 12-week, pilot, case-control trial with quetiapine

Simon Zhornitsky, Emmanuel Stip, Joelle Desfossés, Tania Pampoulova, Élie Rizkallah, Pierre Paul Rompré, Lahcen Aït Bentaleb, Olivier Lipp, Jean Pierre Chiasson, Alain Gendron, Stéphane Potvin

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)

Abstract

Neurological and psychiatric symptoms are consequences of substance abuse in schizophrenia and non-schizophrenia patients. The present case-control study examined changes in substance abuse/dependence, and neurological and psychiatric symptoms in substance abusers with [dual diagnosis (DD) group, n = 26] and without schizophrenia [substance use disorder (SUD) group, n = 24] and in non-abusing schizophrenia patients (SCZ group, n = 23) undergoing 12-week treatment with the atypical antipsychotic, quetiapine. Neurological and psychiatric symptoms were evaluated with the Positive and Negative Syndrome Scale, the Calgary Depression Scale for Schizophrenia, the Extrapyramidal Symptoms Rating Scale, and the Barnes Akathisia Rating Scale. At endpoint, DD and SCZ patients were receiving significantly higher doses of quetiapine (mean = 554 and 478 mg/day, respectively), relative to SUD patients (mean = 150 mg/day). We found that SUD patients showed greater improvement in weekly dollars spent on alcohol and drugs and SUD severity, compared to DD patients. At endpoint, there was no significant difference in dollars spent, but DD patients still had a higher mean SUD severity. Interestingly, DD patients had significantly higher parkinsonism and depression than SCZ patients at baseline and endpoint. On the other hand, we found that SUD patients had significantly more akathisia at baseline, improved more than SCZ patients, and this was related to cannabis abuse/dependence. Finally, SUD patients improved more in Positive and Negative Syndrome Scale positive scores than DD and SCZ patients. Taken together, our results provide evidence for increased vulnerability to the adverse effects of alcohol and drugs in schizophrenia patients. They also suggest that substance abuse/withdrawal may mimic some symptoms of schizophrenia. Future studies will need to determine the role quetiapine played in these improvements.

Original languageEnglish
Article numberArticle 22
JournalFrontiers in Psychiatry
Volume2
Issue numberMAY
DOIs
Publication statusPublished - 2011
Externally publishedYes

Keywords

  • Akathisia
  • Cannabis
  • Paranoia
  • Quetiapine
  • Schizophrenia
  • Substance use disorder

ASJC Scopus subject areas

  • Psychiatry and Mental health

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