SMOKING, SCHIZOPHRENIA, AND ATYPICAL ANTIPSYCHOTICS

精神分裂症患者为什么会有极高的 吸烟的流行率(80%)引起了人们的兴趣 多年来一直从事研究工作。我们已经证明了 在药物治疗期间，患者吸烟显著增加 典型的抗精神病药物氟哌啶醇，但当 患者从氟哌啶醇转向非典型药物治疗 抗精神病药物，氯氮平。 尼古丁纠正感觉门控和认知方面的某些缺陷 精神运动表现没有得到纠正，或变得更糟 氟哌啶醇。氯氮平可以纠正这些缺陷，从而减少 尼古丁对患者的有用性。然而，氯氮平限制了 因为它有潜在的致命副作用，粒细胞缺乏症。 我们将确定，在60名新入院的精神分裂症患者中， 吸烟，无论是用FDA最近批准的非典型药物治疗 抗精神病药物奥氮平与显著降低的分数有关 论吸烟的措施胜过氟哌啶醇的药物治疗 至基线无抗精神病剂期(研究1)。 我们还将采用2x2析因设计，涉及80个回收 表示希望戒烟或戒烟的住院精神分裂症患者 他们吸烟，以确定奥氮平的药物治疗是否 与氟哌啶醇相比，并用尼古丁/甲戊胺预处理 组合与安慰剂/安慰剂组合相比，与更多 戒烟/戒烟治疗的成功结果(研究 2)。

The puzzle of why patients with schizophrenia have extremely high prevalence rates (80 percent) for cigarette smoking has intrigued researchers for many years. We have demonstrated that the amount patients smoke increases significantly during pharmacotherapy with the typical antipsychotic haloperidol, but decreases significantly when patients switch from haloperidol to pharmacotherapy with atypical antipsychotic, clozapine. Nicotine corrects certain deficits in sensory gating and cognitive psychomotor performance that are not corrected, or made worse, by haloperidol. Clozapine corrects these deficits, thereby diminishing the usefulness of nicotine to patients. However, clozapine has restricted use because of its potentially fatal side effect, agranulocytosis. We will determine, in 60 newly admitted patients with schizophrenia who smoke, whether pharmacotherapy with the recently FDA approved atypical antipsychotic, olanzapine, is associated with significantly lower scores on measures of smoking than pharmacotherapy with haloperidol, relative to a baseline antipsychotic-free period (Study 1). We will also utilize a 2 x 2 factorial design, involving 80 recovering inpatients with schizophrenia who express a desire to quit or reduce their smoking, to determine whether pharmacotherapy with olanzapine versus haloperidol, and pretreatment with a nicotine/mecamylamine combination versus placebo/placebo combination, are associated with more successful outcomes during smoking cessation/reduction treatment (Study 2).