Optimizing Treatment for Schizophrenic Smokers

描述：（申请人提供） 精神分裂症患者吸烟的共病率高（高达90 %），并且是典型的尼古丁依赖吸烟者， 戒烟困难。这可能与改善锥体外系有关 副作用，认知功能障碍和信息处理缺陷， 吸烟，以及这两种疾病之间共有的遗传因素。 在过去的三年里，我们的研究计划研究了 吸烟对精神分裂症吸烟者临床和认知功能的影响， 以及药理学和行为治疗方法的发展。 这些研究表明：1）非典型抗精神病药氯氮平可能 减少精神分裂症门诊患者的吸烟量; 2）非典型 抗精神病药物上级典型的抗精神病药物组合 尼古丁贴片用于治疗性戒烟 精神分裂症吸烟者; 3）吸烟可能会增加某些方面的 精神分裂症患者的认知功能，以及; 4）抗吸烟剂 安非他酮（Zyban）似乎是安全和有效的治疗尼古丁 精神分裂症的依赖性这些发现可能对健康 精神分裂症患者的好处，因为许多人往往过早死亡， 与吸烟有关的疾病此外，我们的研究结果还表明， 烟碱受体机制在精神分裂症的生物学中可能是重要的。 在这个随机双盲试验中，我们建议研究最佳策略 在100例尼古丁依赖门诊精神分裂症患者中戒烟 吸烟者。我们将比较安非他酮（n=50）与安慰剂（n=50）的组合 尼古丁贴片和专门的团体治疗计划， 在这些患者中停止。抗精神病药物的作用 （非典型与典型抗精神病药）对治疗反应的影响也将 评估。我们的预测是：1）安非他酮将优于安慰剂上级 精神分裂症患者戒烟; 2）非典型与典型 抗精神病药物治疗状态将增强这些患者的戒烟结果， 患者这项研究的结果可以提供有价值的信息， 精神分裂症患者吸烟的有效药物治疗 患者

DESCRIPTION: (provided by applicant) Schizophrenic patients have high co-morbid rates of cigarette smoking (up to 90 percent), and are typically nicotine dependent smokers who have great difficulty quitting smoking. This may relate to improvement of extrapyramidal side effects, cognitive dysfunction and information processing deficits by cigarette smoking, as well as shared genetic factors between the two disorders. Over the past three years, our research program has studied the effects of cigarette smoking on clinical and cognitive function in schizophrenic smokers, and the development of pharmacological and behavioral treatment approaches. These studies have suggested that: 1) the atypical antipsychotic clozapine may reduce smoking consumption in schizophrenic outpatients; 2) atypical antipsychotic drugs are superior to typical antipsychotic drugs in combination with the nicotine patch for smoking cessation in treatment-motivated schizophrenic smokers; 3) cigarette smoking may enhance some aspects of cognitive function in schizophrenic patients, and; 4) the anti-smoking agent bupropion (Zyban) appears to be safe and effective for treatment of nicotine dependence in schizophrenia. These findings could have important health benefits for schizophrenic patients, as many often die prematurely from smoking-related medical illness. Furthermore, our findings also suggest that nicotinic receptor mechanisms may be important in the biology of schizophrenia. In this randomized, double-blind trial, we propose to study optimal strategies for smoking cessation in n=100 nicotine dependent outpatient schizophrenic smokers. We will compare bupropion (n=50) to placebo (n=50), in combination with nicotine patch and a specialized group therapy program, for smoking cessation in these patients. The effects of antipsychotic medication class (atypical versus typical antipsychotic) on treatment responses will also be evaluated. Our predictions are that: 1) Bupropion will be superior to placebo for smoking cessation in schizophrenia; 2) atypical versus typical antipsychotic treatment status will enhance smoking cessation outcomes in these patients. The results of this study could provide valuable information on effective medication treatments for cigarette smoking in schizophrenic patients.