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Purpose of Review <p>The goal of this review is to evaluate the current evidence on interventional psychiatry treatments, specifically transcranial magnetic stimulation (TMS), ketamine/esketamine, electroconvulsive therapy (ECT), and psychedelic-assisted therapies, for adults with dual diagnosis, defined as the co-occurrence of substance use disorders (SUDs) and psychiatric conditions. The review aims to assess clinical outcomes, safety profiles, and methodological quality of the existing literature.</p> Recent Findings <p>A systematic review was conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) Guidelines, encompassing MEDLINE, EMBASE, and PsycINFO databases. Twenty studies met inclusion criteria (<i>N</i> = 5,863; <i>n</i> = 745 with dual diagnosis), investigating five interventional modalities: TMS (7 studies), ketamine (7 studies), ECT (4 studies), 3,4-Methylenedioxymethamphetamine (MDMA) assisted therapy (1 study), and neurofeedback (1 study). Preliminary evidence suggests that several interventions, particularly deep TMS and intranasal ketamine, may lead to improvements in both psychiatric and substance use symptoms.</p> Summary <p>Interventional psychiatry treatments show promising potential for addressing both dimensions of dual diagnosis, offering novel mechanisms of action that target shared neurobiological pathways involved in mood and reward regulation. Despite encouraging early results and favorable safety profiles, current evidence remains insufficient to support widespread clinical adoption. Larger, well-controlled randomized trials are essential to validate these approaches and inform their integration into standard care for dual-diagnosis populations. This line of inquiry may pave the way for more effective, mechanism-based treatments in an area of high unmet need.</p>

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Innovative and Emerging Interventional Psychiatry Treatments for the Dual Diagnoses of Substance Use and Psychiatric Disorders: A Systematic Review

  • 期刊论文

  • 发表日期：

    2025年9月24日

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  • Huda F. Al-Shamali,
  • Reinhard Janssen-Aguilar,
  • Amaan Hussaini,
  • Vihaan Sharma,
  • Himanshi Elugot,
  • Xin Li,
  • Rakesh Jetly,
  • Yanbo Zhang,
  • Victor Tang,
  • Manish K. Jha,
  • Venkat Bhat

摘要

Purpose of Review

The goal of this review is to evaluate the current evidence on interventional psychiatry treatments, specifically transcranial magnetic stimulation (TMS), ketamine/esketamine, electroconvulsive therapy (ECT), and psychedelic-assisted therapies, for adults with dual diagnosis, defined as the co-occurrence of substance use disorders (SUDs) and psychiatric conditions. The review aims to assess clinical outcomes, safety profiles, and methodological quality of the existing literature.

Recent Findings

A systematic review was conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) Guidelines, encompassing MEDLINE, EMBASE, and PsycINFO databases. Twenty studies met inclusion criteria (N = 5,863; n = 745 with dual diagnosis), investigating five interventional modalities: TMS (7 studies), ketamine (7 studies), ECT (4 studies), 3,4-Methylenedioxymethamphetamine (MDMA) assisted therapy (1 study), and neurofeedback (1 study). Preliminary evidence suggests that several interventions, particularly deep TMS and intranasal ketamine, may lead to improvements in both psychiatric and substance use symptoms.

Summary

Interventional psychiatry treatments show promising potential for addressing both dimensions of dual diagnosis, offering novel mechanisms of action that target shared neurobiological pathways involved in mood and reward regulation. Despite encouraging early results and favorable safety profiles, current evidence remains insufficient to support widespread clinical adoption. Larger, well-controlled randomized trials are essential to validate these approaches and inform their integration into standard care for dual-diagnosis populations. This line of inquiry may pave the way for more effective, mechanism-based treatments in an area of high unmet need.