Nicotine transdermal patch and atypical antipsychotic medications for smoking cessation in schizophrenia
Nicotine transdermal patch and atypical antipsychotic medications for smoking cessation in schizophrenia
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DOI：
10.1176/appi.ajp.157.11.1835
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发表时间：
2000-11-01
影响因子：
17.7
通讯作者：
Kosten, TR
中科院分区：
文献类型：
--
作者：
George, TP;Ziedonis, DM;Kosten, TR
目的：精神分裂症患者吸烟率较高。方法：将45名受试者随机分为1)美国肺脏协会团体戒烟方案(N=17)或2)针对吸烟者的专门团体疗法(N=28)，强调激励、预防复发、社会技能训练和心理教育。所有受试者参加了为期10周的尼古丁透皮贴片(21毫克/天)和每周10次的小组治疗，并继续接受研究前的非典型(N=18)或典型(N=27)抗精神病药物治疗。结果：两组治疗方案的戒烟率无差异。然而，非典型抗精神病药物与尼古丁透皮贴片相结合，显著提高了戒烟率(非典型药物组为55.6%，典型药物组为22.2%)，这反映在非典型药物与典型药物对一氧化碳水平的显著影响上。结论：1)尼古丁透皮贴片对精神分裂症患者的戒烟率不高；2)针对精神分裂症患者的专科团体疗法与美国肺协团体疗法的戒烟效果无显著差异；3)非典型药物联合尼古丁贴片戒烟效果可能优于典型药物。
Objective: Schizophrenic patients have high rates of cigarette smoking. The authors compared the outcomes of two group psychotherapy programs for smoking cessation in patients with schizophrenia or schizoaffective disorder who were also treated with the nicotine transdermal patch and with either atypical or typical antipsychotic medications.Method: Forty-five subjects were randomly assigned to 1) the group therapy program of the American Lung Association (N=17) or 2) a specialized group therapy program for smokers with schizophrenia (N=28) that emphasized motivational enhancement, relapse prevention, social skills training, and psychoeducation. All subjects participated in 10 weeks of treatment with the nicotine transdermal patch (21 mg/day) and 10 weekly group therapy sessions and continued to receive their prestudy atypical (N=18) or typical (N=27) antipsychotic medications. Outcome variables included treatment retention, rate of smoking abstinence, and expired-breath carbon monoxide level.Results: Smoking abstinence rates did not differ in the two group therapy programs. However, atypical antipsychotic agents, in combination with the nicotine transdermal patch, significantly enhanced the rate of smoking cessation (55.6% in the atypical agent group versus 22.2% in the typical group), which was reflected by a significant effect of atypical versus typical agents on carbon monoxide levels. Risperidone and olanzapine were associated with the highest quit rates.Conclusions: The results suggest that I)smoking cessation rates with the nicotine transdermal patch are modest in schizophrenia, 2) specialized group therapy for schizophrenic patients is not significantly different from American Lung Association group therapy in its effect on smoking cessation, and 3) atypical agents may be superior to typical agents in combination with the nicotine transdermal patch for smoking cessation in schizophrenia.