Optimizing Treatment for Schizophrenic Smokers

描述：(申请人提供) 精神分裂症患者吸烟率很高(高达90%) 百分比)，并且通常是尼古丁依赖吸烟者，他们有很好的 戒烟有困难。这可能与锥体外系的改善有关。 副作用、认知功能障碍和信息处理缺陷 吸烟，以及两种疾病之间共有的遗传因素。 在过去的三年里，我们的研究项目研究了 吸烟对精神分裂症吸烟者临床和认知功能的影响 以及药物和行为治疗方法的发展。 这些研究表明：1)非典型抗精神病药物氯氮平可能 减少精神分裂症门诊患者的吸烟消费；2)非典型 抗精神病药物联合用药优于典型的抗精神病药物 尼古丁贴片在戒烟治疗中的应用 精神分裂症吸烟者；3)吸烟可能会在某些方面增强 精神分裂症患者的认知功能；以及；4)禁烟剂 安非他酮(赛班)似乎是安全有效的尼古丁治疗药物 精神分裂症的依赖性。这些发现可能会对健康产生重要的影响 对精神分裂症患者的好处，因为许多人经常因 与吸烟相关的疾病。此外，我们的研究结果还表明， 尼古丁受体机制在精神分裂症的生物学中可能很重要。 在这项随机、双盲试验中，我们建议研究最优策略 用于100例尼古丁依赖门诊精神分裂症患者的戒烟 吸烟者。我们将对安非他酮(n=50)和安慰剂(n=50)进行联合比较 尼古丁贴片和专门的团体治疗计划，用于吸烟 在这些患者中停药。抗精神病药物类药物的作用 (非典型与典型抗精神病药物)对治疗的反应也将是 已评估。我们的预测是：1)安非他酮将优于安慰剂 用于精神分裂症的戒烟；2)非典型与典型 抗精神病药物治疗状况将提高这些患者的戒烟效果 病人。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 病人。

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.