A placebo-controlled trial of bupropion combined with nicotine patch for smoking cessation in schizophrenia
A placebo-controlled trial of bupropion combined with nicotine patch for smoking cessation in schizophrenia
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DOI：
10.1016/j.biopsych.2007.11.002
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发表时间：
2008-06-01
影响因子：
10.6
通讯作者：
Jatlow, Peter I.
中科院分区：
文献类型：
--
作者：
George, Tony P.;Vessicchio, Jennifer C.;Jatlow, Peter I.
背景：精神分裂症患者的吸烟率（58%-88%）高于一般人群（类似于22%），并且难以戒烟。我们确定缓释（SR）安非他酮（BUP）与透皮尼古丁贴片（TNP）联合使用对于精神分裂症患者的戒烟是否耐受性良好，并且优于安慰剂(PLO)+TNP。方法：采用BLIP （300 mg/d）联合TNP （21 mg/24h）治疗58例精神分裂症门诊吸烟者，为期10周的双盲安慰剂对照试验。主要结局指标是在试验的最后4周（第43-70天）持续戒烟，以及在目标戒烟日期（TQD）后6个月（第26周）持续戒烟7天。结果：BUP+TNP组吸烟者（n = 29）比PLO +TNP组吸烟者（n = 29,1/29, 3.4%）更容易实现持续戒烟（8/29,27.6%）[Fisher确切检验，p < 0.05]；在tqd后6个月，4/29（13.8%）和0/29（0.0%）实现了7天的点流行戒烟（p = 0.11）。安非他酮SIR和戒烟均未显著改变精神分裂症的阳性或阴性症状。这种组合在患有精神分裂症的吸烟者中耐受性良好。结论：安非他酮SIR +TNP联合治疗与安慰剂+TNP联合治疗耐受性良好，可显著改善精神分裂症吸烟者的短期戒烟效果。
Background: Individuals with schizophrenia smoke at higher rates (58%-88%) than the general population (similar to 22%), and have difficulty quitting. We determined whether the combination of sustained-release(SR) bupropion (BUP) with the transdermal nicotine patch (TNP)was well-tolerated and superior to placebo (PLO)+TNP for smoking cessation in schizophrenia.Methods: A 10-week, double-blind, placebo-controlled trial of BLIP (300 mg/day) in combination with TNP (21 mg/24h) for 58 outpatient smokers with schizophrenia was conducted. Primary outcome measures were continuous smoking abstinence in the last 4 weeks of the trial (Days 43-70) and 7-day point prevalence abstinence at 6 months post-target quit date (TQD) (week 26).Results: Smokers assigned to the BUP+TNP group (n = 29) were more likely to achieve continuous smoking abstinence (8/29, 27.6%) than the PLO +TNP group (n = 29,1/29, 3.4%) [Fisher's Exact Test, p < .05]; at 6-months post-TQD, 4/29 (13.8%) versus 0/29 (0.0%) achieved 7-day point prevalence smoking abstinence (p = .11). Neither bupropion SIR nor smoking abstinence significantly altered the positive or negative symptoms of schizophrenia. The combination was well-tolerated in smokers with schizophrenia.Conclusions: Combination therapy with bupropion SIR +TNP versus placebo +TNP is well-tolerated and significantly improved short-term smoking abstinence in smokers with schizophrenia.