Dual

What is dual diagnosis?

If you have a dual diagnosis, that means that you have both a mental disorder and a substance use disorder (SUD), either with alcohol or drugs. A dual diagnosis is a type of comorbidity, which is when someone has two disorders at the same time. Another name for this is co-occurring disorders.

Mental and substance use disorders often occur together. Many people who develop SUDs are also diagnosed with mental disorders. And the reverse is true; many people with mental disorders will develop an SUD. Having both types of disorders is even more common in teenagers, people with serious mental illness, and people with certain mental disorders.

Why do substance use disorders and mental disorders occur together?

Although these problems often occur together, this does not mean that one caused the other, even if one appeared first. In fact, it can be hard to figure out which came first. Researchers think that there are three possible reasons as to why they often occur together:

Common risk factors can contribute to both mental disorders and SUDs. These factors include:
- Genetics.
- Stress.
- Trauma, especially in childhood. Veterans with post-traumatic stress disorder (PTSD) are also at risk for SUDs
Mental disorders can contribute to drug use and SUDs. For example, people with mental disorders may use drugs or alcohol to try to feel better temporarily. This is known as self-medication. Also, mental disorders may change the brain to make it more likely that you will become addicted.
Substance use and addiction can contribute to the development of a mental disorder. Substance use may change the brain in ways that make you more likely to develop a mental disorder.

What are the treatments for dual diagnosis?

If you have a dual diagnosis, it is usually better to treat both conditions at the same time rather than separately. You and your health care provider can work on a treatment plan that fits your needs.The plan should take into account your age, which substance(s) you are misusing, and which specific mental disorder(s) you have. The plan may include:

Behavioral therapy, such as talk therapy (psychotherapy), long-term residential treatment (which combines housing and treatment services), and therapies to help you stay motivated to stick with your treatment plan.
Medicines. There are effective medicines that treat opioid, alcohol, and nicotine addiction. There are also medicines that can lessen the symptoms of many mental disorders. Some medicines may treat more than one disorder.
A referral to a support group. Support groups can give you emotional and social support. They are also a place where people can share tips about how to deal with day-to-day challenges.

NIH: National Institute on Drug Abuse

Dual FDA Approved Drugs

BELVIQ [Lorcaserin Hydrochloride]

10mg (oral tablet)

Eisai Inc^{Jun 27, 2012}

Method for chronic weight management by decreasing food intake in an individual who does not have severe renal impairment or esrd.
Method for chronic weight management by decreasing food intake.
Method for chronic weight management by inducing satiety in an individual who does not have severe renal impairment or esrd.
Method for chronic weight management by inducing satiety.
Method for chronic weight management by treating obesity in an individual who does not have severe renal impairment or esrd.
Method for chronic weight management by treating obesity.
Method for chronic weight management.
Method for chronic wieght management by controlling weight gain.
Use of belviq (lorcaserin hydrochloride) for chronic weight management by decreasing food intake in patients on a reduced-calorie diet and who have achieved greater than or equal to 5% weight loss by week 12 of treatment.
Use of belviq (lorcaserin hydrochloride) for chronic weight management by inducing satiety in patients on a reduced-calorie diet and who have achieved a greater than or equal to 5% weight loss by week 12 of treatment.
Use of belviq (lorcaserin hydrochloride) for chronic weight management by treating obesity in patients on a reduced-calorie diet and who have achieved a greater than or equal to 5% weight loss by week 12 of treatment.
Use of belviq (lorcaserin hydrochloride) for chronic weight management in patients on a reduced-calorie diet and who have achieved a greater than or equal to 5% weight loss by week 12 of treatment.

efficacy
0.0 (0)

side effects
0.0 (0)

danger
0.0 (0)

BELVIQ XR [Lorcaserin Hydrochloride]

20mg (oral tablet, extended release)

Eisai Inc^{Jul 15, 2016}

Method for chronic weight management by decreasing food intake in an individual who does not have severe renal impairment or esrd.
Method for chronic weight management by decreasing food intake.
Method for chronic weight management by inducing satiety in an individual who does not have severe renal impairment or esrd.
Method for chronic weight management by inducing satiety.
Method for chronic weight management by treating obesity in an individual who does not have severe renal impairment or esrd.
Method for chronic weight management by treating obesity.
Method for chronic weight management.
Method for chronic wieght management by controlling weight gain.
Use of lorcaserin hydrochloride for chronic weight management by decreasing food intake in patients on a reduced-calorie diet and who have achieved a greater than or equal to 5% weight loss by week 12 of treatment.
Use of lorcaserin hydrochloride for chronic weight management by inducing satiety in patients on a reduced-calorie diet and who have achieved a greater than or equal to 5% weight loss by week 12 of treatment.
Use of lorcaserin hydrochloride for chronic weight management by treating obesity in patients on a reduced-calorie diet and who have achieved a greater than or equal to 5% weight loss by week 12 of treatment.
Use of lorcaserin hydrochloride for chronic weight management in patients on a reduced-calorie diet and who have achieved a greater than or equal to 5% weight loss by week 12 of treatment.

efficacy
0.0 (0)

side effects
0.0 (0)

danger
0.0 (0)

CRESTOR [Rosuvastatin Calcium^{2C₂₂H₂₇FN₃O₆SCa}]

10mg (oral tablet)

20mg (oral tablet)

40mg (oral tablet)

5mg (oral tablet)

Ipr^{Aug 12, 2003}

Treatment of pediatric patients 8 to 17 years of age with heterozygous familial hypercholesterolemia (hefh).
Use of rosuvastatin calcium for the primary prevention of cardiovascular disease in individuals without clinically evident coronary heart disease but with increased risk factors.
Use of rosuvastatin calcium to reduce elevated total-c, ldl-c, apob, nonhdl-c or tg levels; to increase hdl-c in adult patients with primary hyperlipidemia or mixed dyslipidemia; and to slow the progression of atherosclerosis..

efficacy
4.5 (2)

side effects
1.0 (1)

danger
1.0 (1)

CYCLOSET [Bromocriptine Mesylate^{C₃₂H₄₀BrN₅O₅CH₄O₃S}]

eq 0.8mg base (oral tablet)

Veroscience^{May 5, 2009}

Administration once daily within two hours after waking in the morning for improvement of glycemic control in a type 2 diabetes patient.
Improvement of glycemic control in individuals with type 2 diabetes.
Improvements of glycemic control in individuals with type 2 diabetes who have one or more specified cardiovascular risk factors.
Treatment of type 2 diabetes by administering bromocriptine mesylate and a first-phase insulin secretagogue wherein the combined therapeutic effect is greater than the additive effect of administering each agent alone.

efficacy
0.0 (0)

side effects
0.0 (0)

danger
0.0 (0)

M-ZOLE 3 COMBINATION PACK [Miconazole Nitrate^{C₁₈H₁₄Cl₄N₂OHNO₃}]

OTC

2%,200mg (topical, vaginal cream, suppository)

Actavis Mid Atlantic^{Apr 16, 1999}

efficacy
0.0 (0)

side effects
0.0 (0)

danger
0.0 (0)

MICONAZOLE 3 [Miconazole Nitrate^{C₁₈H₁₄Cl₄N₂OHNO₃}]

OTC

4% (vaginal cream)

Taro^{Mar 2, 2005}

efficacy
0.0 (0)

side effects
0.0 (0)

danger
0.0 (0)

MICONAZOLE 3 COMBINATION PACK [Miconazole Nitrate^{C₁₈H₁₄Cl₄N₂OHNO₃}]

OTC

2%,4% (topical, vaginal cream)

Perrigo^{Mar 30, 2004}

efficacy
0.0 (0)

side effects
0.0 (0)

danger
0.0 (0)

MICONAZOLE 7 [Miconazole Nitrate^{C₁₈H₁₄Cl₄N₂OHNO₃}]

OTC

2% (vaginal cream)

Actavis Mid Atlantic^{Mar 29, 1996}

efficacy
0.0 (0)

side effects
0.0 (0)

danger
0.0 (0)

MICONAZOLE 7 COMBINATION PACK [Miconazole Nitrate^{C₁₈H₁₄Cl₄N₂OHNO₃}]

OTC

2%,100mg (topical, vaginal cream, suppository)

G And W Labs^{Mar 26, 2004}

efficacy
0.0 (0)

side effects
0.0 (0)

danger
0.0 (0)

MICONAZOLE NITRATE [Miconazole Nitrate^{C₁₈H₁₄Cl₄N₂OHNO₃}]

OTC / RX

100mg (vaginal suppository)

2% (vaginal cream)

2%,1.2gm (topical, vaginal cream, suppository)

200mg (vaginal suppository)

4% (vaginal cream)

Actavis Pharma^{Nov 19, 1993}
G And W Labs^{Apr 30, 1997}
Perrigo^{Mar 20, 1997}
G And W Labs Inc^{Feb 22, 1996}
Taro^{Jan 13, 1997}
Perrigo R And D^{Jun 2, 2010}

efficacy
0.0 (0)

side effects
0.0 (0)

danger
0.0 (0)

MICONAZOLE NITRATE COMBINATION PACK [Miconazole Nitrate^{C₁₈H₁₄Cl₄N₂OHNO₃}]

OTC

2%,200mg (topical, vaginal cream, suppository)

Perrigo^{Apr 20, 1999}

efficacy
0.0 (0)

side effects
0.0 (0)

danger
0.0 (0)

MONISTAT 1 COMBINATION PACK [Miconazole Nitrate^{C₁₈H₁₄Cl₄N₂OHNO₃}]

OTC

2%,1.2gm (topical, vaginal cream, suppository)

Medtech Products^{Jun 29, 2001}

efficacy
0.0 (0)

side effects
0.0 (0)

danger
0.0 (0)

MONISTAT 3 [Miconazole Nitrate^{C₁₈H₁₄Cl₄N₂OHNO₃}]

RX / OTC

200mg (vaginal suppository)

4% (vaginal cream)

Medtech Products^{Aug 15, 1984}

efficacy
0.0 (0)

side effects
0.0 (0)

danger
0.0 (0)

MONISTAT 3 COMBINATION PACK [Miconazole Nitrate^{C₁₈H₁₄Cl₄N₂OHNO₃}]

OTC

2%,200mg (topical, vaginal cream, suppository)

2%,4% (topical, vaginal cream)

Medtech Products^{Apr 16, 1996}

efficacy
0.0 (0)

side effects
0.0 (0)

danger
0.0 (0)

MONISTAT 3 COMBINATION PACK (PREFILLED) [Miconazole Nitrate^{C₁₈H₁₄Cl₄N₂OHNO₃}]

OTC

2%,4% (topical, vaginal cream)

Medtech Products^{Feb 2, 2001}

efficacy
0.0 (0)

side effects
0.0 (0)

danger
0.0 (0)

MONISTAT 7 [Miconazole Nitrate^{C₁₈H₁₄Cl₄N₂OHNO₃}]

OTC

100mg (vaginal suppository)

2% (vaginal cream)

Medtech Products^{Feb 15, 1991}

efficacy
0.0 (0)

side effects
0.0 (0)

danger
0.0 (0)

MONISTAT 7 COMBINATION PACK [Miconazole Nitrate^{C₁₈H₁₄Cl₄N₂OHNO₃}]

OTC

2%,100mg (topical, vaginal cream, suppository)

Medtech Products^{Apr 26, 1993}

efficacy
0.0 (0)

side effects
0.0 (0)

NIASPAN [Niacin^{C₆H₅NO₂}]

1gm (oral tablet, extended release)

500mg (oral tablet, extended release)

750mg (oral tablet, extended release)

Abbvie^{Jul 28, 1997}

A method of reducing the capacity of extended release nicotinic acid to provoke a flushing reaction by pretreating an individual with a flush inhibiting agent prior to the administration of the extended release nicotinic acid.
Method of treating hyperlipidemia with nicotinic acid by dosing once per day in the evening or at night.
Reduction in elevated tc and ldl-c by dosing once per day in the evening or at night, with pretreatment with a flush inhibitin agent such as aspirin.
Reduction in elevated tc and ldl-c by dosing once per day in the evening or at night.
Reduction in risk of recurrent nonfatal myocardial infarction by dosing once per day in the evening or a t night, with pretreatment with a flush inhibitin agent such as aspirin.
Reduction in risk of recurrent nonfatal myocardial infarction by dosing once per day in the evening or at night.
Reduction in tg by dosing once per day in the evening or at night, with pretreatment with a flush inhibiting agent such as aspirin.
Reduction in tg by dosing once per day in the evening or at night.
Treatment of primary and mixed dyslipidemia by dosing once per day in the evening or at night, with pretreatment with a flush inhibiting agent such as aspirin.
Treatment of primary and mixed dyslipidemia by dosing once per day in the evening or at night.

POMALYST [Pomalidomide^{C₁₃H₁₁N₃O₄}]

1mg (oral capsule)

2mg (oral capsule)

3mg (oral capsule)

4mg (oral capsule)

Celgene^{Feb 8, 2013}

Use of pomalidomide for the treatment of multiple myeloma.
Use of pomalidomide to inhibit the secretion of pro-inflammation cytokines, including tumor necrosis factor alpha.
Use of pomalidomide while preventing the exposure of a fetus or other contraindicated individual to pomalidomide.

REVLIMID [Lenalidomide^{C₁₃H₁₃N₃O₃}]

10mg (oral capsule)

15mg (oral capsule)

2.5mg (oral capsule)

20mg (oral capsule)

25mg (oral capsule)

Celgene^{Dec 27, 2005}

Treatment of male patient having a disease or condition responsive to a teratogenic drug.
Use of revlimid (lenalidomide) for the treatment of mantle cell lymphoma (mcl).
Use of revlimid (lenalidomide) for the treatment of multiple myeloma and transfusion-dependent anemia in myelodysplastic syndromes (mds).
Use of revlimid (lenalidomide) for the treatment of multiple myeloma.
Use of revlimid (lenalidomide) for the treatment of transfusion-dependent anemia in myelodysplastic syndromes (mds).
Use of revlimid (lenalidomide) to inhibit the secretion of pro-inflammatory cytokines, including tumor necrosis factor alpha.
Use of revlimid (lenalidomide) while preventing the exposure of a fetus or other contraindicated individual to revlimid (lenalidomide).

THALOMID [Thalidomide^{C₁₃H₁₀N₂O₄}]

100mg (oral capsule)

150mg (oral capsule)

200mg (oral capsule)

Celgene^{Jan 17, 2003}

Acute treatment of the cutaneous manifestations of moderate to severe erythema nodosum leprosum (enl).
Approval for marketing only under a special restriction program approved by fda called 'system for thalidomide education and prescribing safety' (s.t.e.p.s.).
Maintenance therapy for prevention and supression of the cutaneous manifestations of enl recurrence.
Method for delivering a drug to a patient in need of the drug, while avoiding the occurence of an adverse side effect known or suspected of being caused by said drug.
Treatment of cutaneous manifestations of erythema nodosum leprosum (enl) in connection with a special program approved by fda called 'system for thalidomide education and prescribing safety' (s.t.e.p.s.).
Treatment of male patient having a disease or condition responsive to a teratogenic drug.
Use in combination with dexamethasone is indicated for the treatment of patients with newly diagnosed multiple myeloma.
Use of thalidomide in combination with dexamethasone for the treatment of patients with newly diagnosed multiple myeloma.
Use of thalidomide in treatment of cutaneous manifestations of erythema nodosum leprosum (enl).
Use of thalidomide while preventing the exposure of a fetus or other contraindicated individual to thalidomide.

WARNING: Consult a licensed physician in the appropriate field for medical treatment and drug prescription. Do not self medicate.

WARNING: All medicines, drugs, plants, chemicals or medicial precedures below are for historical reference only. Many of these treatments are now known to be harmful and possibly fatal. Do not consume any plant, chemical, drug or otherwise without first consulting a licensed physician that practices medine in the appropriate field.

Felter's Materia Medica on Dual

ASAFOETIDA (Ferula fetida)
A gum-resin derived from the rhizome and rootlets of Ferula Asafetida, Linné; Ferula foetida, Regel, and other species of Ferula (Nat. Ord.... / ...very useful nervine for functional spasmodic affections. It is especially adapted to neurotic individuals subject to hysterical or emotional attacks, usually attended by flatulent distention of the ab... / ...or tardy or imperfect menstruation. Asafetida is contraindicated by inflammation. It may be given in emulsion, tincture, or pill or capsule. ¹

CACTUS (Selenicereus spp.)
...le, in some instances, to correct structural abnormalities. Valvular troubles have been noted to gradually disappear under its prolonged administration. Unlike digitalis it does not disorder the stoma...... be due to lack of innervation, associated with mental depression, or in excitable or nervous individuals, the remedy relieves, because its tendency is to promote normal rhythmic action of the cardiac...¹

CAMPHORA
A stearopten (having the nature of a ketone) derived from Cinnamomum Camphora. (Linné), Nees et Ebermeier (Nat. Ord. Lauraceae). China and... / ...t tends to suppress the milk. The spirit is in common use as a lotion for headache in nervous individuals with feeble circulation, and tendency to fainting. The oil, by injection, is sometimes effectu... / ...due to gaseous distention of the stomach, or to nervous irritability. In occipital headache, from mental strain, or overstudy, small doses of ¹

CANNABIS
...ridiculous character, the nature of which he fully comprehends, but is wholly unable to prevent. Gradually passing into a dream-like stage, he talks, volubly, brilliantly, with everrecurring changes o......efore his distorted mental vision. A singular peculiarity is a state of double consciousness or dual personality which possesses him in which he imagines he is both himself and some one else, and ......affectionate to the extreme, both to himself and to others, and altogether he is a very happy individual leading a very full and infinitely extended life. Finally drowsiness overtakes him and he drops...¹

CASCARA SAGRADA
The dried bark of Rhamnus Purshiana, De Candolle (Nat. Ord. Rhamnaceae). A shrub of Northern Idaho and the Pacific coast. Dose, 5 to 30... / ...n, and may be given for a considerable time without increase of dosage. In fact, the dose may be gradually decreased from day to day often with the result of completely curing the constipation. Cascar... / ...Dose: One half to one teaspoonful at bedtime. If a more profound action is desired a half drachm of Specific Medicine Podophyllum may be added.¹

COLCHICUM^COLCH
The dried (I) root and (II) seed of Colchicum autumnale, Linné (Nat. Ord. Liliaceae.) England and other parts of Europe. Dose, Corm, 1 to 5... / ...0 drops. Specific Indications.-Acute gout; rheumatism, without much fever, occurring in gouty individuals; tearing pain, aggravated by heat. Action and Toxicology.Upon the skin and mucosa colchicum ...¹

CONVALLARIA^CONVA
The rhizome and rootlets of Convallaria majalis, Linné (Nat. Ord. Liliaceae.) Common Name: Lily of the Valley. Principal Constituents.Two... / ...men, hepatic fullness and engorgement, and edema-symptoms of this form of cardiac insufficiency, gradually disappear under small and continued doses of this drug. Moderate doses calm cardiac excitemen... / ...carditis and endocarditis, using it in fractional doses. Convallaria is of less service in stenosis of the aorta than in mitral disorders.¹

CORALLORHIZA
The rhizome of Corallorhiza odontorhiza, Nuttall. (Nat. Ord. Orchidaceae.) Rich woods in eastern half of the United States. Dose, 1 drachm. Common... / ..., cough and pain cease, there is better action of the kidneys and skin, and general recuperation gradually takes place. For dry bronchial irritation, with wheezing, tightness of the chest, paroxysms o... / ...agent is too expensive to use for these purposes. It is to be regretted that its extreme scarcity makes corallorhiza an almost unobtainable drug.¹

DIOSCOREA
The rhizome of Dioscorea villosa, Linné (Nat. Ord. Dioscoreaceae). A vine found throughout the United States. Dose, 5 to 60 grains. Common Names: Wild Yam, Colic Root. Principal... / ...e calculi. Usually, while there is much tenderness in cases requiring dioscorea, the distress is gradually relieved by pressure.¹

ELATERIUM
The feculence of the juice of the fruit of Ecballium Elaterium (Linné), A. Richard. (Nat. Ord. Cucurbitaceae.) A trailing vine of southern... / ... the most powerful and the best of the hydragogue cathartics. As such it is indicated only in individuals strong enough to stand depletion, and is always contraindicated in the weak and feeble. Overdo... / ...is preferred by some physicians, though elaterium, notwithstanding its impurities, seems to be more generally efficient than its derivative.¹

FICUS
The fleshy receptacle of Ficus Carica, Linné bearing fruit on its inner surface. (Nat. Ord.... / ...etid ulcers. Internal. Nutritive, demulcent, and aperient. Figs are frequently resorted to by individuals inclined to constipation. An elegant aperient confection is employed by the laity under the ho......es. This is wrapped in tinfoil, and sliced off and eaten according to the requirements of the individual.¹

GELSEMIUM
The dried rhizome and roots of Gelsemium sempervirens (Linné,) Aiton (Nat. Ord. Loganiaceae). Dose, 1/10 to 1 grain. Common Names: Yellow... / ...for great restlessness with elevation of temperature; for the touchy and grouchy but feverish individual who magnifies his ailments; and for those who dread even the simple ordeals and trials of life.... / ...great restlessness and excitation are the classic indications for it as first formulated by Scudder, and these stand among the truest of speci¹

GRINDELIA
The dried leaves and flowering tops of one or several species of Grindeliaas Grindelia camporum, Greene; or Grindelia squarrosa (Pursh), Dunal.... / ...ness. The accompanying cough is dry and harsh and the breathing labored, causing in plethoric individuals a dusky coloration of the face. In some cases it promptly stops the paroxysms of asthma, and i... / ...over the spleen, sallow skin, debility and indigestion, with gastric distress. The bitter taste of grindelia is best disguised by chloroform.¹

HUMULUS
The strobiles of Humulus Lupulus, Linné (Nat. Ord. Urticaceae). Europe and Asia; common in cultivation. Common Names: Hops, Hop. Principal... / ... device for procuring sleep. The odor of the hop has a decidedly sedative influence upon some individuals, relieving headache and producing sleep; in others it produces intense headache, with nausea a... / ...useful in fermentative dyspepsia with acid eructations. For other uses see Lupulinum, which has superseded hops largely as an internal medicine.¹

IPECACUANHA (Cephaelis Ipecacuanha).
...ptions and sometimes ulcers. When inhaled it causes heat and violent sneezing. In susceptible individuals the powdered drug excites pronounced attacks simulating asthma, the chief symptoms being great......s decidedly irritant to mucous surfaces, particularly that of the nasal passages, and in some individuals will precipitate an attack simulating spasmodic asthma. It increases biliary activity, is expe...¹

Physician's Therapeutics Memoranda on Dual

DIABETES MELLITUS
Exclude sugar and starch as far as possible from the diet, but do not starve the patient. The... / ...alicylic acid, salicylates, potassium iodide. Other remedies are methylene blue (2 to 5 grs. three times a day), uranium nitrate (2 grs. increased gradually to 10 or more, after each meal). Tonics must be prescribed as indicated, arsenic, iron, g1ycerophos phates and strychnine being particularly us...²

FEVER
The remedies commonly resorted to include; 1st cardiac or ar terial sedatives, particularly aconite, 2d antipyretics causing... / ... serviceable, 4th sedatives and anodynes, which may well be combined with diaphoretics. These several classes of remedies must be suited to the individual case, bearing in mind the fact that fever is not in and of itself necessarily an evil thing.²

GONORRHEA
Free irrigation twice a day with a hot solution of potassium per manganate (1 grain increased gradually to 3 grs. to the pint); Iodosyl Pencils, with internal use of Ze-an; injections of silver nitrate or protargol, zinc acetate, mercuric chloride. Internally copaiba, oil sandalwood, cubeb. Treatment for acute gonorrhea should be con tinued until gonococci have completely disappeared.²

References

1) Felter, Harvey Wickes, 1922, The Eclectic Materia Medica, Pharmacology and Therapeutics, Cincinnati, Ohio.
2) Nelson, Baker & Co., 1904, Physician's Handy Book of Materia Medica and Therapeustics, Detroit, Michigan.

Ledgend of Medicine

MODERN MEDICINES

HOME REMEDIES

RANDOM DRUGS

RANDOM AILMENTS

Dual

Dual FDA Approved Drugs

Felter's Materia Medica on Dual

Physician's Therapeutics Memoranda on Dual

References