Concomitant clozapine reduces smoking in patients treated with risperidone

Procyshyn, Ric M.; Tse, Gordon; Sin, Osric; Flynn, Sean W.

doi:10.1016/s0924-977x(01)00130-4

Cited by 40 publications

(24 citation statements)

References 22 publications

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“…Other studies have indicated that clozapine helps patients with schizophrenia reduce cigarette smoking [25,26]. Recent work indicates that augmentation of risperidone with clozapine results in significantly lower rates of nicotine use in patients with schizophrenia than use of risperidone alone [27].…”

Section: Atypical Antipsychoticsmentioning

confidence: 99%

Treatment of substance use disorders in schizophrenia: A unifying neurobiological mechanism?

Roth¹,

Brunette²,

Green

2005

Curr Psychiatry Rep

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Substance use disorders (SUDs) are highly prevalent and are associated with poor outcomes among individuals with schizophrenia. Integrating treatments for both disorders improves outcomes. Numerous individual pharmacologic and psychosocial treatments have shown effectiveness at reducing substance use in individuals with a primary diagnosis of schizophrenia and co-occurring substance use disorders. Of these treatments, medications such as certain atypical antipsychotics and naltrexone, and psychosocial treatments such as contingency management, seem to be particularly promising. The development and evaluation of psychopharmacologic and psychosocial treatments for SUDs in schizophrenia would benefit from a better understanding of the neurobiological mechanisms underlying the effectiveness of such treatments. Several theories have been put forth to explain the heightened risk for SUDs in schizophrenia. Of these, brain reward circuitry dysfunction, hypothesized to be etiologically important in SUDs, may be an especially salient target for treatments aimed at the reduction of substance use in patients with schizophrenia. We review current pharmacologic and psychosocial treatments for SUDs in schizophrenia, and theoretical mechanisms underlying the increased risk for SUDs in this population. We propose that effective treatments may in part work through the modulation of brain reward circuitry dysfunction.

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Section: Atypical Antipsychoticsmentioning

confidence: 99%

Treatment of substance use disorders in schizophrenia: A unifying neurobiological mechanism?

Roth¹,

Brunette²,

Green

2005

Curr Psychiatry Rep

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“…The use of atypical antipsychotics to treat primary schizophrenia has been reported to result in spontaneous reductions in heavy smoking as well as improved outcomes in tobacco addiction treatment programs for schizophrenic patients [88], and should be considered as part of a treatment plan for smokers with schizophrenia. Clozapine may have a unique advantage in this regard [89,90].…”

Section: Schizophreniamentioning

confidence: 99%

Management of smoking in people with psychiatric disorders

Ziedonis¹,

Williams²

2003

Current Opinion in Psychiatry

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Purpose of reviewThe rates of tobacco addiction in individuals with psychiatric disorders (mental illness and addiction) continue to remain alarmingly high despite substantial decreases in smoking in the general population. Recent findings suggest that tobacco addiction treatment can be effective for smokers with psychiatric disorders, but will require both clinical interventions and systems changes. There is both an immediate need to address tobacco in this population and to expand research agendas to include the many remaining clinical questions for this population. Recent findingsNearly half of all cigarettes consumed in the United States are smoked by individuals with psychiatric disorders, who are at two to three times the risk of developing tobacco-related medical illnesses. Recent international studies have found high rates of heavy smoking among those with psychiatric disorders similar to those in the United States. Under-recognition and under-treatment of tobacco addiction in this population continues to be common despite the availability of effective management approaches. Smokers with psychiatric disorders are a broad treatment population that requires treatment specificity according to subtypes. Nicotine replacement medication, bupropion, atypical antipsychotics, and modified psychosocial treatments can improve outcomes. The effective model programs and system changes that have begun to address tobacco in this population have often not been published, disseminated, or replicated. Summary There continue to be relatively few treatment studies for this population, and the existing studies have small sample sizes. Research should test whether effective treatments used in the general population will work for this population. Program development and system changes should be described and evaluated. Abbreviations CBTcognitive behavioral therapy FDA Food and Drug Administration NRT nicotine replacement therapy SSRI selective serotonin reuptake inhibitor

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“…Evidence suggests that the FTND can predict relapse and can be used to tailor pharmacotherapy (e.g., Alterman, Gariti, Cook, & Cnaan, 1999 ;Campbell, Prescott, & Tjeder-Burton, 1996 ;Patten, Martin, Calfas, Lento, & Wolter, 2001 ;West, 2005 ;Westman, Behm, Simel, & Rose, 1997 ; see also Fagerström & Schneider, 1989 ). However, these fi ndings are not consistent (e.g., Borrelli, Spring, Niaura, Hitsman, & Papandonatos, 2001 ;Gilbert, Crauthers, Mooney, McClernon, & Jensen, 1999 ;Kenford et al, 1994 ;Procyshyn, Tse, Sin, & Flynn, 2002 ;Silagy, Mant, Fowler, & Lodge, 1994 ). Some data suggest that the lion's share of predictive validity is concentrated in only a subset of FTND items (e.g., the number of cigarettes smoked per day, time to fi rst cigarette; Dale et al, 2001 ;Heatherton, Kozlowski, Frecker, Rickert, & Robinson, 1989 ;Razavi et al, 1999 ;Shiffman, Dresler, Hajek, Gilburt, Targett, & Strahs, 2002 ;Transdisciplinary Tobacco Use Research Center [TTURC] Tobacco Dependence Phenotype Workgroup et al, 2007 ).…”

Section: Introductionmentioning

confidence: 99%

The Wisconsin Predicting Patients' Relapse questionnaire

Bolt

Piper²,

McCarthy³

et al. 2009

Nicotine & Tobacco Research

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Introduction: Relapse is the most common smoking cessation outcome. Accurate prediction of relapse likelihood could be an important clinical tool used to infl uence treatment selection or duration. The aim of this research was to develop a brief clinical relapse proneness questionnaire to be used with smokers interested in quitting in a clinical setting where time is at a premium. Methods:Diverse items assessing constructs shown in previous research to be related to relapse risk, such as nicotine dependence and self-effi cacy, were evaluated to determine their independent contributions to relapse prediction. In an exploratory dataset, candidate items were assessed among smokers motivated to quit smoking who enrolled in one of three randomized controlled smoking cessation trials. A cross-validation dataset was used to compare the relative predictive power of the new instrument against the Fagerström Test for Nicotine Dependence (FTND) at 1-week, 8-week, and 6-month postquit assessments. Results:We selected seven items with relatively nonoverlapping content for the Wisconsin Predicting Patient's Relapse (WI-PREPARE) measure, a brief, seven-item questionnaire that taps physical dependence, environmental factors, and individual difference characteristics. Cross-validation analyses suggested that the WI-PREPARE demonstrated a stronger prediction of relapse at 1-week and 8-week postquit assessments than the FTND and comparable prediction to the FTND at a 6-month postquit assessment. Discussion:The WI-PREPARE is easy to score, suggests the nature of a patient's relapse risk, and predicts short-and medium-term relapse better than the FTND.

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Concomitant clozapine reduces smoking in patients treated with risperidone

Cited by 40 publications

References 22 publications

Treatment of substance use disorders in schizophrenia: A unifying neurobiological mechanism?

Treatment of substance use disorders in schizophrenia: A unifying neurobiological mechanism?

Management of smoking in people with psychiatric disorders

The Wisconsin Predicting Patients' Relapse questionnaire

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