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.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
1R01DA013672-01A1
Application #
6383599
Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Montoya, Ivan
Project Start
2001-09-01
Project End
2005-05-31
Budget Start
2001-09-01
Budget End
2002-05-31
Support Year
1
Fiscal Year
2001
Total Cost
$211,950
Indirect Cost
Name
Yale University
Department
Psychiatry
Type
Schools of Medicine
DUNS #
082359691
City
New Haven
State
CT
Country
United States
Zip Code
06520
Wing, Victoria C; Tang, Yi-Lang; Sacco, Kristi A et al. (2013) Effect of COMT Val(158)Met genotype on nicotine withdrawal-related cognitive dysfunction in smokers with and without schizophrenia. Schizophr Res 150:602-3
Morisano, Dominique; Wing, Victoria C; Sacco, Kristi A et al. (2013) Effects of tobacco smoking on neuropsychological function in schizophrenia in comparison to other psychiatric disorders and non-psychiatric controls. Am J Addict 22:46-53
Mackowick, Kristen M; Lynch, Marie-Josee; Weinberger, Andrea H et al. (2012) Treatment of tobacco dependence in people with mental health and addictive disorders. Curr Psychiatry Rep 14:478-85
Moss, Taryn G; Weinberger, Andrea H; Vessicchio, Jennifer C et al. (2010) A tobacco reconceptualization in psychiatry: toward the development of tobacco-free psychiatric facilities. Am J Addict 19:293-311
Hitsman, Brian; Moss, Taryn G; Montoya, Ivan D et al. (2009) Treatment of tobacco dependence in mental health and addictive disorders. Can J Psychiatry 54:368-78
Weinberger, Andrea H; Hitsman, Brian; Papandonatos, George D et al. (2009) Predictors of abstinence and changes in psychiatric symptoms in a pooled sample of smokers with schizophrenia receiving combination pharmacotherapy and behavioral therapy for smoking cessation. J Clin Psychopharmacol 29:601-3
Rabin, Rachel A; Sacco, Kristi A; George, Tony P (2009) Correlation of prepulse inhibition and Wisconsin Card Sorting Test in schizophrenia and controls: effects of smoking status. Schizophr Res 114:91-7
Moss, Taryn G; Sacco, Kristi A; Allen, Taryn M et al. (2009) Prefrontal cognitive dysfunction is associated with tobacco dependence treatment failure in smokers with schizophrenia. Drug Alcohol Depend 104:94-9
Yip, Sarah W; Sacco, Kristi A; George, Tony P et al. (2009) Risk/reward decision-making in schizophrenia: a preliminary examination of the influence of tobacco smoking and relationship to Wisconsin Card Sorting Task performance. Schizophr Res 110:156-64
Morisano, Dominique; Bacher, Ingrid; Audrain-McGovern, Janet et al. (2009) Mechanisms underlying the comorbidity of tobacco use in mental health and addictive disorders. Can J Psychiatry 54:356-67

Showing the most recent 10 out of 30 publications