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Samir Kasper,Jasmin Softić,Hassan Awad,Hajrudin Hasečić Cantonal Institute for Addictive Disorders

Replacement therapy in the treatment of the addicts with dual psychiatric diagnosis-five years of experience. Samir Kasper,Jasmin Softić,Hassan Awad,Hajrudin Hasečić Cantonal Institute for Addictive Disorders Zenica,Bosnia and Herzegovina.

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Samir Kasper,Jasmin Softić,Hassan Awad,Hajrudin Hasečić Cantonal Institute for Addictive Disorders

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  1. Replacement therapy in the treatment of the addicts with dual psychiatric diagnosis-five years of experience Samir Kasper,Jasmin Softić,Hassan Awad,Hajrudin Hasečić Cantonal Institute for Addictive Disorders Zenica,Bosnia and Herzegovina

  2. -This paper aims to show to experience of our institution in the application of replacement therapy in the treatment of opiate addicts with a dual psychiatric diagnosis. -Retrospective analysis of the treatment of opiate addiction with a dual psychiatric diagnosis treatment at the hospital´s department Institute for Addictions Ze-Do Canton in the period 2008-13.years -Criteria for inclusion in the study were: Hospital treatment in our department in the period 2008-13 Relevant tests diagnosed addiction to opiates and dual psychiatric diagnoses

  3. Treatment substitution therapy (methadone and buprenorphine / naloxone -Criteria for exclusion from the study were: Relevant tests confirmed the absence of dual psychiatric diagnoses among patients treated in our hospital institution. -The diagnostic process of patients, the following methods: Clinical psychiatric and neurological examination, IQ Test,MMPI 202 Test,Beck Depression Inventory-II,Beck Anxiety Inventory and Structured Clinical Interwiev. - In this period, 345 were treated opiate addicts and in 149 (43.18%) was placed on a dual psychiatric diagnosis.

  4. Results • 110 patients (73.82%) were treated with methadone • 39 patients (26.18%) were treated with buphrenorphine/naloxone • In the group of patients treated with methadone indepedently of other tretment modalities significantly improvement was registred in the group of patients with psychotic and personaly disorders

  5. Results • In 60% of these patients there was a significant reduction of primary psychopathology: aggression, delusions, hallucinations and de-realization. • n the group of patients with mood disorders only 45% of patients responded positively to treatment with methadone and 2 cases due to depression treatment procedure had to be terminated

  6. Results • In the group of patients with psychotic disorders and personality disorders 40% of patients responded positively to treatment buprenorphine / naloxone but in 10 patients deterioration which required treatment antipsychotic medications. • n the group of patients with mood disorders and neurotic disorders, 80% of the patients responded favorably to treatment buprenorphine / nlatreoxon without significant adverse effects

  7. Conclusions • Opiate agonists have an important place in the treatment of opiate addicts with dual psychiatric diagnosis and to draw conclusions about their indication field, additional investigations are needed

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