Table 1.

Studies of Pharmacologic Interventions for AUD Among Individuals Who Have Schizophrenia Spectrum Disorders

Medication	Participants and Design	Results
Naltrexone32	Individuals (N = 31) with schizophrenia and co-occurring alcohol abuse or dependence* were treated with naltrexone (50 mg) or placebo, in addition to neuroleptic medication, for a 12-week, randomized controlled trial.	Participants treated with naltrexone, compared to those who received placebo, had significantly fewer drinking days and fewer heavy-drinking days (defined as more than five drinks), and they reported less craving.
Naltrexone and Disulfiram34	Individuals (N = 254) with alcohol dependence* and heterogeneous psychiatric disorders were treated with disulfiram and naltrexone alone and in combination. They also received intensive psychosocial treatment during the 12-week, randomized controlled trial.	Individuals with a psychotic spectrum disorder who received an active medication had better alcohol use outcomes when compared with those who received placebo. Neither disulfiram nor naltrexone nor the combination had a clear advantage.
Disulfiram37	In this retrospective review, individuals (N = 33) with alcohol abuse or dependence* and severe mental illness had been treated with disulfiram.	At a 3-year follow-up, 64% of individuals experienced remission of alcohol abuse or dependence* for at least 1 year.
Acamprosate35	Individuals (N = 23) with a diagnosis of alcohol dependence* and co-occurring schizophrenia, schizoaffective disorder, or nonspecified psychosis received acamprosate or placebo in a randomized controlled trial.	All participants reduced drinking. Acamprosate was not superior to placebo in increasing consecutive days of abstinence. Participants who received acamprosate reported significantly fewer obsessive thoughts of drinking than those who received placebo.
Valproic Acid39	Individuals (N = 59) with bipolar I disorder and alcohol dependence* received either valproate or placebo in a randomized controlled trial. All participants received treatment as usual (which included lithium).	The group that received valproate had a significantly smaller proportion of heavy-drinking days and a trend toward fewer drinks per heavy-drinking day when compared to the group that received placebo.
Varenicline41	Individuals (N = 55) with schizophrenia or schizoaffective disorder and concurrent alcohol and nicotine dependence* received varenicline or placebo in a pilot, 8-week, randomized controlled trial.	Because of safety concerns or loss to follow-up, only 10 participants started the study. Five received varenicline and five received placebo. Adverse gastrointestinal effects such as severe abdominal pain limited study completion to four participants.

^*Study used the classifications of alcohol abuse and alcohol dependence as defined in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders.