The dually diagnosed patient with psychotic symptoms.

The dual diagnoses of substance use disorder with other psychiatric disorder is especially problematic in psychotic or other chronically mentally ill patients. Such patients have a more fragile mental status which can be adversely affected by psychoactive substances of abuse. In addition, most such patients need to take potent psychiatric medications which themselves may interact with substances. This article reviews substance induced versus true comorbid major psychiatric disorders and discusses the major classes of psychiatric medications in terms of abuse potential and their abilities to either help or hinder substance disorder recovery.