Nicotine Dependence and Schizophrenia

Use of legal drugs by psychiatric outpatients: Benefits, costs, and change

“…As many as three-quarters of patients with schizophrenia smoke (Goff, Henderson, & Amico, 1992;Ziedonis, Kosten, Glazer, & Frances, 1994) compared to one-quarter of the general population. In addition to the established risks for cancer and heart disease, additional deleterious effects may accrue for smokers receiving psychiatric treatment.…”

“…Cigarette smoking increases hepatic enzyme action, hastening the elimination of drugs that depend on hepatic metabolism, thereby reducing plasma concentration of some therapeutic drugs (Perry, Miller, Arndt, Smith, & Holman, 1993). Persons with schizophrenia who smoke have also received higher ratings of positive symptoms (Goff et al, 1992;Ziedonis et al, 1994). Although cause and effect relationships are not clear, nicotine may exacerbate psychotic symptoms and reduce the effectiveness of antipsychotic medications.…”

“…In contrast, only 9% of the general population consumes as much caffeine (Greden, Fontaine, Lubetsky, & Chamberlain, 1978). Excessive caffeine use can have deleterious effects on mental status, increasing anxiety and depression (Greden et al, 1978;Winstead, 1976), and exacerbating psychotic symptoms in persons with schizophrenia (Carey & Carey, 1989;Mikkelsen, 1978).As many as three-quarters of patients with schizophrenia smoke (Goff, Henderson, & Amico, 1992;Ziedonis, Kosten, Glazer, & Frances, 1994) compared to one-quarter of the general population. In addition to the established risks for cancer and heart disease, additional deleterious effects may accrue for smokers receiving psychiatric treatment.…”

Abnormal Regulation of High Affinity Nicotinic Receptors in Subjects with Schizophrenia

“…The up-regulation of receptor numbers does not appear to be under transcriptional regulation (Marks et al 1992). Rather, the increases may be related to changes in receptor turnover based on receptor desensitization, subunit composition, secondary structural changes in the receptor, or to modification of the receptor by protein kinases (Peng et al 1994;Baenziger and Chew 1997;Eilers et al 1997;Flores et al 1997;Hsu et al 1997;Xiao et al 1998;Fenster et al 1999).In spite of the high degree of nicotine self-administration in schizophrenics (Lohr and Flynn 1992;Ziedonis et al 1994;de Leon et al 1995), few studies have examined the effect of smoking or neuroleptic treatment on nicotinic receptor regulation in this disease (Dalack et al 1998). It has been suggested that nicotine self-administration in schizophrenics may control a neuronal deficit.…”

“…In spite of the high degree of nicotine self-administration in schizophrenics (Lohr and Flynn 1992;Ziedonis et al 1994;de Leon et al 1995), few studies have examined the effect of smoking or neuroleptic treatment on nicotinic receptor regulation in this disease (Dalack et al 1998). It has been suggested that nicotine self-administration in schizophrenics may control a neuronal deficit.…”