Third-Generation Antipsychotics and Lurasidone in the Treatment of Substance-Induced Psychoses: A Narrative Review.

Third-generation antipsychotics (aripiprazole, cariprazine, brexpiprazole, and lurasidone) show promise for treating substance-induced psychosis, a condition triggered by substance misuse or withdrawal that features prominent hallucinations, delusions, mood disturbances, and cognitive issues. Substances such as cannabinoids, cocaine, amphetamines, and LSD are especially likely to induce psychosis. The review describes each drug's unique pharmacological properties and neurotransmitter interactions, suggesting they may address both psychotic symptoms and substance misuse. The authors call for more research on long-term effects and advocate combining medication with psychological treatments, emphasizing the complexity of managing substance-induced psychosis.

Study at a glance

Abstract

This narrative review explores the efficacy and tolerability of third-generation antipsychotics (TGAs)-aripiprazole, cariprazine, brexpiprazole, and lurasidone-for the management of substance-induced psychosis (SIP). SIP is a psychiatric condition triggered by substance misuse or withdrawal, characterized by unique features distinct from those of primary psychotic disorders. These distinctive features include a heightened prevalence of positive symptoms, such as hallucinations and delusions, in addition to a spectrum of mood and cognitive disturbances. This review comprehensively investigates various substances, such as cannabinoids, cocaine, amphetamines, and LSD, which exhibit a greater propensity for inducing psychosis. TGAs exhibit substantial promise in addressing both psychotic symptoms and issues related to substance misuse. This review elucidates the distinctive pharmacological properties of each TGA, their intricate interactions with neurotransmitters, and their potential utility in the treatment of SIP. We advocate for further research to delineate the long-term effects of TGAs in this context and underscore the necessity for adopting an integrated approach that combines pharmacological and psychological interventions. Our findings underscore the intricate and multifaceted nature of treating SIP, highlighting the potential role of TGAs within therapeutic strategies.