Dual Diagnosis: Why Treating One Without the Other Never Works

Mental health conditions and addiction are deeply intertwined, creating complex treatment challenges that require addressing both simultaneously. Dr. Mark Hrymoc, an addiction psychiatrist, shares insights on effectively treating dual diagnosis patients through parallel treatment plans that address both substance use and underlying mental health conditions.

• Dual diagnosis (co-occurring disorders) describes patients with both mental health conditions and substance use disorders
• Many patients use substances to self-medicate underlying mental health conditions rather than for euphoria
• 50-80% of patients with addiction also have PTSD or significant trauma histories
• SSRIs like Zoloft and Lexapro are first-line treatments for anxiety disorders including PTSD
• Prazosin is effective for PTSD-related nightmares
• Propranolol, clonidine, and gabapentin offer non-addictive options for anxiety management
• ADHD is a major risk factor for developing substance use disorders
• Non-stimulant options like Strattera, Qelbree, and Wellbutrin should be tried first for ADHD with comorbid addiction
• Insomnia treatment options include trazodone, mirtazapine, quetiapine, and newer DORA medications
• Ketamine therapy shows promise for treatment-resistant depression and suicidality

Remember, treating addiction saves lives.

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