Effect of Nicotine Replacement Therapy on Agitation in Smokers With Schizophrenia: A Double-Blind, Randomized, Placebo-Controlled Study
Effect of Nicotine Replacement Therapy on Agitation in Smokers With Schizophrenia: A Double-Blind, Randomized, Placebo-Controlled Study
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DOI：
10.1176/appi.ajp.2010.10040569
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发表时间：
2011-04-01
影响因子：
17.7
通讯作者：
Damsa, Cristian
中科院分区：
文献类型：
--
作者：
Allen, Michael H.;Debanne, Martin;Damsa, Cristian
目的：作者进行了一项随机，安慰剂对照研究尼古丁替代疗法减少吸烟者的躁动和侵略精神分裂症。方法：参与者是40名吸烟者18-65岁的精神病急诊服务，确诊为精神分裂症的迷你国际神经精神访谈。采用阳性和阴性综合征量表（PANSS）的兴奋成分子量表筛选患者的激越，采用尼古丁依赖的Fagerstrom试验筛选尼古丁依赖。PANSS兴奋成分子量表评分至少为14分，Fagerstrom检验评分至少为6分，才有资格参加研究。尼古丁替代组的参与者接受21 mg尼古丁透皮贴剂，安慰剂组的参与者接受安慰剂贴剂治疗。参与者接受抗精神病药物的常规护理。激动行为量表和其他激动措施，在基线，并再次在4和24 hours.Results：在基线，参与者至少中度激动，和28%的报告在前一周的攻击性行为。尼古丁替代组的平均躁动行为量表评分在4小时时比安慰剂组低33%，在24小时时比安慰剂组低23%。尼古丁依赖水平较低的参与者的反应比那些具有较高水平的dependence.Conclusions：在这项研究中的药物安慰剂的差异是相似的，在类似的人群中，肠外抗精神病药物的试验。这一发现表明，在精神分裂症患者中，吸烟状态应包括在评估激越和尼古丁替代治疗包括那些谁是吸烟者。
Objective: The authors conducted a randomized, placebo-controlled study of nicotine replacement therapy for the reduction of agitation and aggression in smokers with schizophrenia.Method: Participants were 40 smokers 18-65 years of age admitted to a psychiatric emergency service with a diagnosis of schizophrenia confirmed by the Mini International Neuropsychiatric Interview. Patients were screened for agitation with the excited component subscale of the Positive and Negative Syndrome Scale (PANSS) and for nicotine dependence with the Fagerstrom Test for Nicotine Dependence. A score of at least 14 on the PANSS excited component subscale and at least 6 on the Fagerstrom test were required for study eligibility. Participants in the nicotine replacement group received a 21-mg nicotine transdermal patch, and those in the placebo group were treated with a placebo patch. Participants received usual care with antipsychotics. The Agitated Behavior Scale and other agitation measures were administered at baseline and again at 4 and 24 hours.Results: At baseline, participants were at least moderately agitated, and 28% reported aggressive behavior in the previous week. The mean Agitated Behavior Scale score for the nicotine replacement group was 33% lower at 4 hours and 23% lower at 24 hours than for the placebo group. Participants with lower levels of nicotine dependence responded better than those with higher levels of dependence.Conclusions: The drug-placebo difference in this study was similar to that obtained in trials of parenteral antipsychotics in similar populations. This finding suggests that in patients with schizophrenia, smoking status should be included in the assessment of agitation and nicotine replacement included in the treatment of those who are smokers.