Solvents, whose use is widely prevalent across the world, are one of the most common illicit drugs abused in Kerala, especially among the adolescents. However, few solvent users come in contact with the health care system due to their disenfranchisement and social isolation. This selective review outlines the current concepts and clinical management strategies related to solvent use and related disorders. No robust studies are currently available on treatment approaches, and all published treatment guidelines have been based on expert consensus. There are few case reports on use of baclofen, buspirone and lamotrigine in reducing craving and treating solvent dependence. Risperidone, haloperidol and carbamazepine are reported to be effective in the treatment of solvent induced psychosis. Recommended nonpharmacological approaches include cognitive, group, and behavior therapies. Many other aspects of solvent dependence, including course and outcome, have not been studied, despite the fact that use of solvents is associated with significant mortality, morbidity and psychosocial dysfunction. There is an urgent need for a concerted effort to develop effective evidence based interventions to tackle this issue.
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