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Medications Development for the Treatment of Nicotine Dependence in Individuals with Schizophrenia
Journal of Dual Diagnosis ( IF 1.5 ) Pub Date : 2007-11-01 , DOI: 10.1300/j374v03n03_09
Ivan D Montoya 1 , Frank Vocci
Affiliation  

ABSTRACT The development of medications for the treatment of nicotine dependence in patients with schizophrenia is a public health priority due to its high prevalence rates, devastating medical consequences, and difficulty to treat. It has been hypothesized that the high prevalence of nicotine dependence among patients with schizophrenia may be due to a shared neurobiological vulnerability. This shared vulnerability has been evidenced in reports showing that nicotine improves neuropsychological deficits associated with schizophrenia such as in the P50 evoked auditory potentials, spatial working memory, and attention. The common pathophysiologic pathways of smoking and schizophrenia may serve as the basis for the pharmacological evaluation of medications for the treatment of these concurrent disorders. Currently, little research of medications for the treatment of this comorbidity has been conducted. Studies have evaluated the efficacy of smoking cessation medications in patients with schizophrenia. These include the nicotine replacement therapy (patch, nasal spray) and sustained release bupropion. Others have evaluated the anti-smoking effect of medications (e.g., clozapine, haloperidol) used for the treatment of schizophrenia. In both cases, the results have not been conclusive. Newer smoking cessation approaches such as varenicline, selegiline, rimonabant, and nicotine vaccine, among others, have yet to be tested in this population. The purpose of this article is to review the results of the studies conducted to date and propose some potential pharmacotherapies based on the current knowledge of the pathophysiology of both disorders.

中文翻译:

治疗精神分裂症患者尼古丁依赖的药物开发

摘要 开发治疗精神分裂症患者尼古丁依赖的药物是公共卫生的重点,因为其患病率高、医疗后果严重且难以治疗。据推测,精神分裂症患者尼古丁依赖的高流行率可能是由于共同的神经生物学脆弱性。这种共同的脆弱性已在报告中得到证实,该报告显示尼古丁改善了与精神分裂症相关的神经心理缺陷,例如 P5​​0 诱发的听觉电位、空间工作记忆和注意力。吸烟和精神分裂症的常见病理生理学途径可以作为治疗这些并发疾病的药物的药理学评价的基础。目前,对治疗这种合并症的药物研究很少。研究评估了戒烟药物对精神分裂症患者的疗效。这些包括尼古丁替代疗法(贴剂、鼻喷雾剂)和缓释安非他酮。其他人评估了用于治疗精神分裂症的药物(例如氯氮平、氟哌啶醇)的抗吸烟作用。在这两种情况下,结果都不是决定性的。较新的戒烟方法如伐尼克兰、司来吉兰、利莫那班和尼古丁疫苗等尚未在该人群中进行测试。本文的目的是回顾迄今为止进行的研究结果,并根据目前对这两种疾病的病理生理学知识提出一些潜在的药物疗法。
更新日期:2007-11-01
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