SMOKING, SCHIZOPHRENIA, AND ATYPICAL ANTIPSYCHOTICS

Project: Research project

Project Details

Description

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).
StatusNot started

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