Salín-Pascual RJ, Delgado-Parra V

Language: Spanish
References: 19
Page: 200-205
PDF size: 80.16 Kb.

ABSTRACT

Background: Nicotine addiction is a common problem in psychiatric patients specially schizophrenics, in which approximately 70% are nicotine dependent. Cessation rates were lower in schizophrenia smokers versus the general population. The main goal of the present study was to reduced cigarette smoking in schizophrenic patients using transdermal nicotine patches and to determine if this therapeutic manipulations had some impact in their clinical manifestation. Method: Schizophrenic patients who smoke were invited to participate in the present study in which nicotine-patches were offer in order to reduce the number of cigarettes or even to quit smoking. Patients were assessed with the Brief Psychiatric Rating Scale (BPRS), at the beginning of the protocol and after the fifth and the tenth week with nicotine patches. Two doses of nicotine patches were administered depending on the daily amount of cigarettes that each patient use to smoke: less than 15 cigarette/day, 17.5 mg of nicotine-patch, if patients whom smoke more than 16 cigarettes per day, a 35 mg patches were used. Active patches were used during five weeks, and that was followed by another five weeks of placebo patches. Results: A total of 30 schizophrenic patients were studied, twenty were males. The administration of nicotine patches produced a reduction of cigarette smoking more pronounced in 17.5 mg group. Seventeen patients, from 17.5 mg nicotine-patches (100%) reduced the number of cigarettes below the half (50%), and four out of 17 patients stop smoking at all (23.5%). Ten patients in the 35 mg group reduced smoking below 50% during the five weeks with nicotine patches, but none of them stop smoking at all. When patients shift to placebo patches, fourteen and four of the 17.5 mg and 35 mg respectively, persisted below 50% of baseline smoking cigarettes, but only one in the first group stop smoking at all. A decrease of craving from the first week and the following nicotine weeks was observed when patients were on active patches, without significant differences between groups, smoking appetence increase when patients were on placebo patches, again without differences between both groups. In both nicotine-patches groups, BPRS showed a non significant reduction when patients were in active patches. But when patients were on placebo there was a significant increase in the overall BPRS scale. Conclusion: The present study demonstrated that substitute therapy with nicotine patches could be useful in patients with low profile of smoking, and also that heavy smokers, are more susceptible to any change in their average dose. The addition of other type of medication like bupropion or atypical antipsychotics could reduce even more the consumption of tobacco and conduce to abstinent status. There is need for more of this kind of studies in the future.

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