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Lombardozzi G, Trovini G, Amici E, Kotzalidis GD, Perrini F, Giovanetti V, Di Giovanni A, De Filippis S. Brexpiprazole in patients with schizophrenia with or without substance use disorder: an observational study. Front Psychiatry 2023; 14:1321233. [PMID: 38111619 PMCID: PMC10725927 DOI: 10.3389/fpsyt.2023.1321233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 11/13/2023] [Indexed: 12/20/2023] Open
Abstract
Background Partial dopamine D2 receptor agonists are used for psychotic symptoms in adults with schizophrenia spectrum disorders. Recently, interest surged for partial dopamine D2 receptor agonists in substance use disorders (SUDs). Since it is believed that SUDs decrease the efficacy of pharmacotherapy of underlying psychiatric disorders, we tested the efficacy of the partial D2 agonist brexpiprazole in patients with schizophrenia who were either comorbid with a SUD (SUD group) or not comorbid (non-SUD) to assess treatment response and the effect of brexpiprazole on substance craving in SUD. Methods We included patients with DSM-5/DSM-5-TR schizophrenia (using SCID-5-CV) aged 18-66 years with either comorbid SUD or non-SUD to treat with brexpiprazole 4 mg/day for 6 months during February-October 2022. Patients were assessed with the Clinical Global Impressions-Severity (CGI-S) scale, the 24-item Brief Psychiatric Rating Scale (BPRS), and the Positive And Negative Syndrome Scale (PANSS) at baseline, weekly for the first 2 months and monthly for the next four. Furthermore, we assessed substance craving in SUD with a visual analog scale for craving (VAScrav) at the same timepoints. Results The total sample was 86 (85 analysable) 18- to 64-year-old (mean 39.32 ± 14.09) patients with schizophrenia [51 men (59.3%) and 35 women (40.7%)], of whom 48 SUD (55.8%) (37 men and 11 women) and 38 non-SUD (44.2%) (14 men and 24 women). No serious or persistent adverse events developed over the study period, but one patient dropped out for subjective akathisia. Results indicated the main effects of time with improvements over the course of the study for CGI-S, BPRS, and PANSS in both SUD and non-SUD groups and the entire sample, and for VAScrav in SUD. Brexpiprazole was associated with similar significant improvements in both groups at the 6 month endpoint compared to baseline. Conclusion Treatment with brexpiprazole for 6 months improved psychotic symptoms in patients with schizophrenia, independently from whether they belonged to the SUD or the non-SUD group; hence, SUD comorbidity did not confer treatment resistance to brexpiprazole. Furthermore, in the SUD group, we observed reduced substance craving.
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Affiliation(s)
- Ginevra Lombardozzi
- Villa Von Siebenthal Neuropsychiatric Hospital and Clinic, Genzano di Roma, Italy
| | - Giada Trovini
- Villa Von Siebenthal Neuropsychiatric Hospital and Clinic, Genzano di Roma, Italy
| | - Emanuela Amici
- Villa Von Siebenthal Neuropsychiatric Hospital and Clinic, Genzano di Roma, Italy
| | - Georgios D. Kotzalidis
- Villa Von Siebenthal Neuropsychiatric Hospital and Clinic, Genzano di Roma, Italy
- NESMOS Department, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome, Italy
- Centro Lucio Bini, Rome, Italy
| | | | - Valeria Giovanetti
- Villa Von Siebenthal Neuropsychiatric Hospital and Clinic, Genzano di Roma, Italy
| | | | - Sergio De Filippis
- Villa Von Siebenthal Neuropsychiatric Hospital and Clinic, Genzano di Roma, Italy
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Lunding SH, Ueland T, Aas M, Høegh MC, Werner MCF, Rødevand L, Johansen IT, Hjell G, Ormerod MBEG, Ringen PA, Ottesen A, Lagerberg TV, Melle I, Andreassen OA, Simonsen C, Steen NE. Tobacco smoking related to childhood trauma mediated by cognitive control and impulsiveness in severe mental disorders. Schizophr Res 2023; 261:236-244. [PMID: 37806047 DOI: 10.1016/j.schres.2023.09.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 05/26/2023] [Accepted: 09/24/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND People with severe mental disorders (SMDs) show an increased prevalence of tobacco smoking compared to the general population. Tobacco smoking and other adult adverse health behaviors have been associated with traumatic experiences in childhood. In the present study we investigated the relationship between childhood trauma and tobacco smoking in people with SMDs, including the possible mediating role of cognitive- and personality characteristics, i.e. cognitive control, impulsiveness, affective lability and self-esteem. METHODS Enrolled in the study were 871 participants with schizophrenia (SCZ, N = 484) and bipolar (BD, N = 387) spectrum disorders. We assessed tobacco smoking behavior (yes/no and amount), and history of childhood trauma with the Childhood Trauma Questionnaire. Data on cognitive control, impulsiveness, affective lability, and self-esteem were available in subsamples. We performed linear and logistic regressions, and conducted mediation analyses in PROCESS. All analyses were as standard adjusted for age, sex, and diagnostic group. RESULTS Experience of one or more subtypes of childhood trauma was significantly associated with smoking tobacco in SMDs (p = 0.002). There were no significant associations between childhood trauma and amount of tobacco smoking. Cognitive control and impulsiveness were significant mediators between childhood trauma and tobacco smoking. CONCLUSIONS These findings indicate the experience of childhood trauma as a predisposing factor for tobacco smoking in SMDs. Cognitive control and impulsiveness were suggested as mediating mechanisms, indicating the importance of considering inhibition related self-regulatory aspects in efforts to improve health behavior in individuals with SMDs and childhood trauma.
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Affiliation(s)
- Synve Hoffart Lunding
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Torill Ueland
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway
| | - Monica Aas
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Margrethe Collier Høegh
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Maren Caroline Frogner Werner
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Linn Rødevand
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Torp Johansen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Gabriela Hjell
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatry, Ostfold Hospital, Graalum, Norway
| | | | - Petter Andreas Ringen
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Akiah Ottesen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Trine Vik Lagerberg
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Melle
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Carmen Simonsen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Early Intervention in Psychosis Advisory Unit for South East Norway, Oslo University Hospital, Oslo, Norway
| | - Nils Eiel Steen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Chai Y, Chu RYK, Hu Y, Lam ICH, Cheng FWT, Luo H, Wong MCS, Chan SSM, Chan EWY, Wong ICK, Lai FTT. Association between cumulative exposure periods of flupentixol or any antipsychotics and risk of lung cancer. COMMUNICATIONS MEDICINE 2023; 3:126. [PMID: 37752185 PMCID: PMC10522572 DOI: 10.1038/s43856-023-00364-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 09/18/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Preclinical evidence suggests that certain antipsychotic medications may inhibit the development of lung cancer. This study aims to investigate the association between incident lung cancer and different cumulative exposure periods of flupentixol or any antipsychotics. METHODS Using electronic health records from the Hospital Authority in Hong Kong, this nested case-control study included case participants aged 18 years or older with newly diagnosed lung cancer after initiating antipsychotics between January 1, 2003, and August 31, 2022. Each case was matched to up to ten controls of the same sex and age, who were also antipsychotic users. Multivariable conditional logistic regression models were conducted to quantify the association between lung cancer and different cumulative exposure times of flupentixol (0-365 days [ref]; 366-1825 days; 1826+ days) and any antipsychotics (1-365 days [ref]; 366-1825 days; 1826+ days), separately. RESULTS Here we show that among 6435 cases and 64,348 matched controls, 64.06% are males, and 52.98% are aged 65-84 years. Compared to patients with less than 365 days of exposure, those with 366-1825 days of exposure to flupentixol (OR = 0.65 [95% CI, 0.47-0.91]) and any antipsychotics (0.42 [0.38-0.45]) have a lower risk of lung cancer. A decreased risk is observed in patients who have 1826+ days of cumulative use of any antipsychotics (0.54 [0.47-0.60]). CONCLUSIONS A reduced risk of lung cancer is observed in patients with more than one year of exposure to flupentixol or any antipsychotics. Further research on the association between lung cancer and other antipsychotic agents is warranted.
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Affiliation(s)
- Yi Chai
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- The Hong Kong Jockey Club Center for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, China
| | - Rachel Yui Ki Chu
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Yuqi Hu
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Ivan Chun Hang Lam
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Franco Wing Tak Cheng
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Hao Luo
- The Hong Kong Jockey Club Center for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, China
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR, China
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong SAR, China
| | - Martin Chi Sang Wong
- Centre for Health Education and Health Promotion, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Sandra Sau Man Chan
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Esther Wai Yin Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Hong Kong SAR, China
| | - Ian Chi Kei Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Hong Kong SAR, China.
| | - Francisco Tsz Tsun Lai
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Hong Kong SAR, China.
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
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Keady J, Fisher M, Anderson E, LeMalenfant R, Turner J. Age-specific impacts of nicotine and withdrawal on hippocampal neuregulin signalling. Eur J Neurosci 2022; 56:4705-4719. [PMID: 35899607 PMCID: PMC9710301 DOI: 10.1111/ejn.15780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 05/30/2022] [Accepted: 07/20/2022] [Indexed: 11/29/2022]
Abstract
Smoking remains the leading cause of preventable death in the United States, with 87% of smokers starting before the age of 18. Age of initiation is a major predictive factor for smoking frequency and successful smoking cessation. People who initiate smoking during adolescences are 2.33 times more likely to become heavy smokers and half as likely to quit compared with smokers who started during adulthood. Additionally, schizophrenia, a disease state linked to altered neurodevelopment during adolescence, is a major predictive factor for smoking status. Smoking rates among people suffering from schizophrenia are between 60% and 90%. Interestingly, the Neuregulin Signalling Pathway (NSP), which plays an important role in neurodevelopment, is implicated in both schizophrenia and nicotine use disorder. Specifically, SNPS in neuregulin 3 (Nrg3) and Erb-B2 Receptor Tyrosine Kinase 4 (ErbB4) have been associated with smoking cessation outcomes and schizophrenia. Here, we examine the effects of chronic nicotine (18 mg/kg/day) and 24-h withdrawal on NSP gene expression in the hippocampus of adult (20-week-old) and adolescent (4-week-old) mice. We show that withdrawal from chronic nicotine decreased the expression of Erbb4 mRNA in the hippocampus of the adult mice but increased the expression of cytosolic Erbb4 protein in adolescent mice. Nrg3 mRNA and protein expression was not altered by chronic nicotine or withdrawal in the adult or adolescent cohorts, but Nrg3 mRNA and synaptosomal protein expression was lower in the adult withdrawal group when compared with their adolescent counterparts. These results highlight the age-specific effects of nicotine withdrawal on the NSP and may contribute to the lower quit rate and higher cigarette consumption of smokers who initiation during adolescences.
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Affiliation(s)
- Jack Keady
- Department of Pharmaceutical Sciences, University of Kentucky College of Pharmacy, Lexington, Kentucky 40536–0596, USA
| | - Miranda Fisher
- Department of Pharmaceutical Sciences, University of Kentucky College of Pharmacy, Lexington, Kentucky 40536–0596, USA
| | - Erin Anderson
- Department of Drug Discovery and Biomedical Sciences, South Carolina College of Pharmacy, University of South Carolina, Columbia, SC, USA
| | - Rachel LeMalenfant
- Department of Drug Discovery and Biomedical Sciences, South Carolina College of Pharmacy, University of South Carolina, Columbia, SC, USA
| | - Jill Turner
- Department of Pharmaceutical Sciences, University of Kentucky College of Pharmacy, Lexington, Kentucky 40536–0596, USA
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Rajalu BM, Jayarajan D, Muliyala KP, Sharma P, Gandhi S, Chand PK, Thirthalli J, Murthy P. Non-pharmacological interventions for smoking in persons with schizophrenia spectrum disorders - A systematic review. Asian J Psychiatr 2021; 56:102530. [PMID: 33465747 DOI: 10.1016/j.ajp.2020.102530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 11/20/2020] [Accepted: 12/16/2020] [Indexed: 01/16/2023]
Abstract
INTRODUCTION The rates and intensity of tobacco use are higher in persons with schizophrenia spectrum disorders (PwS) compared to the general population, contributing to increased morbidity and mortality. We aimed to systematically review randomised control trials (RCTs) that used non-pharmacological interventions to reduce or cease tobacco use in PwS. METHODS We searched PubMed, EBSCO, ProQuest and PsycINFO for RCTs, published between January 2004 and December 2019, which included adult PwS. Studies providing self-reported or biochemically measured reduction of tobacco use and cessation after a minimum follow-up period of 6 months were included. We used the Cochrane Risk of Bias (ROB) tool for assessing the quality of selected studies. RESULTS Of the six included trials, two compared non-pharmacological interventions alone while four compared combinations with pharmacological interventions with routine care. The non-pharmacological interventions varied widely. Continuous abstinence and seven days point-prevalence abstinence (7 PPA) were reported in 2 and 4 studies respectively, with one study assessing both. All six trials measured reduction in the number of cigarettes smoked, but only two trials reported significant reductions in intervention groups. No worsening of psychiatric symptoms was reported. CONCLUSIONS Two trials were rated as "low risk", and 4 trials as "some concerns" on the ROB tool. Heterogeneity among trials precluded meta-analysis. Abstinence was significantly higher among groups who were given combination interventions, and intervention groups in studies showed significantly greater or a trend towards reduction in the number of cigarettes smoked than controls. No specific method of non-pharmacological management was conclusively favoured. IMPLICATIONS Reduction in cigarettes smoked seemed to significantly favour or show non-significant trends favouring intervention groups over controls, while abstinence was significantly higher among groups in studies that used specific combination interventions. Combinations of pharmacological and non-pharmacological treatment were better than non-pharmacological interventions used in isolation, for facilitating abstinence and reduction in cigarettes smoked. Specific interventions such as home visits and contingent reinforcement merit further study. Trials included in this study were conducted in high-income and upper-middle-income countries. Thus, the application of these interventions to low and middle-income countries (LAMICs) needs to be further studied.
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Affiliation(s)
- Banu Manickam Rajalu
- Psychiatric Rehabilitation Services, National Institute of Mental Health and Neurosciences, Bangalore, 560029, India.
| | - Deepak Jayarajan
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, 560029, India.
| | - Krishna Prasad Muliyala
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, 560029, India.
| | - Priyamvada Sharma
- Centre for Addiction Medicine, Department of Clinical Pharmacology and Neurotoxicology, National Institute of Mental Health and Neurosciences, Bangalore, 560029, India.
| | - Sailaxmi Gandhi
- Department of Nursing, National Institute of Mental Health and Neurosciences, Bangalore, 560029, India.
| | - Prabhat Kumar Chand
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, 560029, India.
| | - Jagadisha Thirthalli
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, 560029, India.
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, 560029, India.
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Johnson SE, Mitrou F, Lawrence D, Zubrick SR, Wolstencroft K, Ennals P, Hall C, McNaught E. Feasibility of a Consumer Centred Tobacco Management intervention in Community Mental Health Services in Australia. Community Ment Health J 2020; 56:1354-1365. [PMID: 32036516 DOI: 10.1007/s10597-020-00573-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 02/01/2020] [Indexed: 11/29/2022]
Abstract
This study tested a new program for helping smokers with severe mental illness to reduce their tobacco use, together with determining the feasibility of such research in community mental health settings in Australia. Five Neami National sites trialled a Consumer Centred Tobacco Management program called Kick the Habit (n = 34). The intervention included two weeks of free Nicotine Replacement Therapy (patches only) but participants also used a variety of self-funded delivery types in addition or as an alternative to the subsidised nicotine patch. At the 3-month follow-up, Kick the Habit participants had reduced their number of daily cigarettes, dependency levels and average weekly expenditure on tobacco. Although a larger study is required, Kick the Habit represents a promising intervention for tobacco management in community mental health services. The challenges and lessons learnt for scaling up to a larger trial and integration into business-as-usual practice across multiple sites are discussed.
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Affiliation(s)
- Sarah E Johnson
- Telethon Kids Institute, The University of Western Australia, Perth, Australia.
- Telethon Kids Institute, Northern Entrance, Perth Children's Hospital, 15 Hospital Avenue, Nedlands, WA, 6009, Australia.
| | - Francis Mitrou
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
- Centre for Child Health Research, The University of Western Australia, Perth, Australia
| | - David Lawrence
- Graduate School of Education, The University of Western Australia, Perth, Australia
| | - Stephen R Zubrick
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
- Centre for Child Health Research, The University of Western Australia, Perth, Australia
| | | | | | - Cristal Hall
- Neami National (Head Office), Melbourne, Australia
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Underner M, Perriot J, Brousse G, de Chazeron I, Schmitt A, Peiffer G, Harika-Germaneau G, Jaafari N. Arrêt et réduction du tabac chez le patient souffrant de schizophrénie. L'ENCEPHALE 2019; 45:345-356. [PMID: 31153585 DOI: 10.1016/j.encep.2019.04.067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 04/18/2019] [Accepted: 04/22/2019] [Indexed: 02/08/2023]
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8
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Cosci F, Mansueto G, Zamboni L, Lugoboni F. Cigarette smoking in subjects maintained with methadone or buprenorphine: The role of psychiatric symptoms and psychological distress. J Psychosom Res 2019; 122:82-87. [PMID: 31003855 DOI: 10.1016/j.jpsychores.2019.04.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 04/10/2019] [Accepted: 04/11/2019] [Indexed: 01/31/2023]
Abstract
OBJECTIVE The relationship between cigarette smoking, psychiatric symptoms/psychological distress in subjects maintained with methadone or buprenorphine was studied. METHODS 1049 subjects with a diagnosis of heroin use disorder were enrolled. The Symptom Checklist-90-Revised (SCL-90-R) and the General Health Questionnaire-12 (GHQ-12) were administered. The analyses were run in the whole sample and stratified for substitution therapies. RESULTS In the whole sample as well as among subjects maintained with methadone, the number of cigarettes smoked daily was associated with SCL-90-R Global score (whole sample: p = 0.001; ΔR2 = 0.012; subjects maintained with methadone: p ≤ 0.001; ΔR2 = 0.019) and with GHQ-12 (whole sample: p = 0.001; ΔR2 = 0.013; subjects maintained with methadone: p = 0.01; ΔR2 = 0.010) while among subjects maintained with buprenorphine, the number of cigarettes smoked daily was associated with SCL-90-R Global score (p = 0.05; ΔR2 = 0.020). CONCLUSION Psychiatric symptoms were associated with the number of cigarettes smoked daily among subjects maintained with methadone and among those maintained with buprenorphine, thus deserving clinical attention.
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Affiliation(s)
- Fiammetta Cosci
- Department of Health Sciences, University of Florence, Florence, Italy; Department of Psychiatry & Psychology, University of Maastricht, Maastricht, the Netherlands.
| | - Giovanni Mansueto
- Department of Health Sciences, University of Florence, Florence, Italy; Department of Psychiatry & Psychology, University of Maastricht, Maastricht, the Netherlands
| | - Lorenzo Zamboni
- Addiction Unit, Verona University Hospital, piazzale Aristide Stefani 1, 37126 Verona, Italy
| | - Fabio Lugoboni
- Addiction Unit, Verona University Hospital, piazzale Aristide Stefani 1, 37126 Verona, Italy
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9
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Mallet J, Le Strat Y, Schürhoff F, Mazer N, Portalier C, Andrianarisoa M, Aouizerate B, Berna F, Brunel L, Capdevielle D, Chereau I, D'Amato T, Dubreucq J, Faget C, Gabayet F, Honciuc RM, Lançon C, Llorca PM, Misdrahi D, Rey R, Roux P, Schandrin A, Urbach M, Vidailhet P, Fond G, Dubertret C. Tobacco smoking is associated with antipsychotic medication, physical aggressiveness, and alcohol use disorder in schizophrenia: results from the FACE-SZ national cohort. Eur Arch Psychiatry Clin Neurosci 2019; 269:449-457. [PMID: 29396753 DOI: 10.1007/s00406-018-0873-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 01/24/2018] [Indexed: 12/31/2022]
Abstract
Tobacco smoking is common in schizophrenia and is one of the main causes of premature mortality in this disorder. Little is known about clinical correlates and treatments associated with tobacco smoking in patients with schizophrenia. Still, a better characterization of these patients is necessary, in a personalized care approach. Aggressiveness and childhood trauma have been associated with tobacco smoking in general population, but this association has never been explored in schizophrenia. Our study examines the clinical and therapeutic characteristics of tobacco smoking in schizophrenia. 474 stabilized patients (mean age = 32.2; 75.7% male gender; smokers n = 207, 54.6%) were consecutively included in the network of the FondaMental Expert centers for Schizophrenia and assessed with valid scales. Current tobacco status was self-declared. Aggressiveness was self-reported with Buss-Perry Aggressiveness Questionnaire and Childhood Trauma with Childhood Trauma Questionnaire. Ongoing treatment was reported. In univariate analysis, tobacco smoking was associated with lower education level (p < 0.01), positive syndrome (p < 0.01), higher physical aggressiveness (p < 0.001), alcohol dependence (p < 0.001), and First Generation Antipsychotics (FGAs) use (p = 0.018). In a multivariate model, tobacco smoking remained associated with physical aggressiveness (p < 0.05), current alcohol dependence (p < 0.01) and FGA use (p < 0.05). No association was observed with childhood trauma history, mood disorder, suicidal behavior, psychotic symptom, global functioning or medication adherence. Patients with tobacco use present clinical and therapeutic specificities, questioning the neurobiological links between tobacco and schizophrenia. They could represent a specific phenotype, with specific clinical and therapeutic specificities that may involve interactions between cholinergic-nicotinic system and dopaminergic system. Further longitudinal studies are needed to confirm the potential efficacy of second generation antipsychotics (SGAs) on tobacco use in schizophrenia and to develop effective strategies for tobacco cessation in this population.
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Affiliation(s)
- J Mallet
- Fondation FondaMental, Créteil, France. .,AP-HP, Paris, France. .,Department of Psychiatry, Service de Psychiatrie et d'Addictologie, Hôpital Louis Mourier, 178 rue des Renouillers, 92700, Colombes, France. .,Inserm U894, Paris, France. .,Sorbonne Paris Cité, Faculté de Médecine, Université Paris Diderot, Paris, France.
| | - Y Le Strat
- Fondation FondaMental, Créteil, France.,AP-HP, Paris, France.,Department of Psychiatry, Service de Psychiatrie et d'Addictologie, Hôpital Louis Mourier, 178 rue des Renouillers, 92700, Colombes, France.,Inserm U894, Paris, France.,Sorbonne Paris Cité, Faculté de Médecine, Université Paris Diderot, Paris, France
| | - F Schürhoff
- Fondation FondaMental, Créteil, France.,INSERM U955, Équipe de Psychiatrie Translationnelle, Créteil, France.,Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - N Mazer
- Fondation FondaMental, Créteil, France.,AP-HP, Paris, France.,Department of Psychiatry, Service de Psychiatrie et d'Addictologie, Hôpital Louis Mourier, 178 rue des Renouillers, 92700, Colombes, France.,Inserm U894, Paris, France.,Sorbonne Paris Cité, Faculté de Médecine, Université Paris Diderot, Paris, France
| | - C Portalier
- Fondation FondaMental, Créteil, France.,AP-HP, Paris, France.,Department of Psychiatry, Service de Psychiatrie et d'Addictologie, Hôpital Louis Mourier, 178 rue des Renouillers, 92700, Colombes, France.,Inserm U894, Paris, France.,Sorbonne Paris Cité, Faculté de Médecine, Université Paris Diderot, Paris, France
| | - M Andrianarisoa
- Fondation FondaMental, Créteil, France.,INSERM U955, Équipe de Psychiatrie Translationnelle, Créteil, France.,Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - B Aouizerate
- Fondation FondaMental, Créteil, France.,Centre Hospitalier Charles Perrens, 33076, Bordeaux, France.,Université de Bordeaux, Bordeaux, France.,Bordeaux Sleep Clinique, Pellegrin University Hospital, Bordeaux University, USR CNRS 3413 SANPSY, Research Unit, 33000, Bordeaux, France.,Inserm, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, 33000, Bordeaux, France
| | - F Berna
- Fondation FondaMental, Créteil, France.,Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - L Brunel
- Fondation FondaMental, Créteil, France.,INSERM U955, Équipe de Psychiatrie Translationnelle, Créteil, France.,Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - D Capdevielle
- Fondation FondaMental, Créteil, France.,Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - I Chereau
- Fondation FondaMental, Créteil, France.,CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003, Clermont-Ferrand Cedex 1, France
| | - T D'Amato
- Fondation FondaMental, Créteil, France.,INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678, Bron Cedex, France
| | - J Dubreucq
- Fondation FondaMental, Créteil, France.,Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - C Faget
- Fondation FondaMental, Créteil, France.,Pôle Psychiatrie Universitaire, CHU Sainte-Marguerite, 13274, Marseille Cedex 09, France
| | - F Gabayet
- Fondation FondaMental, Créteil, France.,Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - R M Honciuc
- Fondation FondaMental, Créteil, France.,CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003, Clermont-Ferrand Cedex 1, France
| | - C Lançon
- Fondation FondaMental, Créteil, France.,Assistance Publique des Hôpitaux de Marseille (AP-HM), Pôle Universitaire de Psychiatrie, Marseille, France
| | - P M Llorca
- Fondation FondaMental, Créteil, France.,CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003, Clermont-Ferrand Cedex 1, France
| | - D Misdrahi
- Fondation FondaMental, Créteil, France.,Centre Hospitalier Charles Perrens, 33076, Bordeaux, France.,Université de Bordeaux, Bordeaux, France.,CNRS UMR 5287-INCIA, Bordeaux, France
| | - R Rey
- Fondation FondaMental, Créteil, France.,INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678, Bron Cedex, France
| | - P Roux
- Fondation FondaMental, Créteil, France.,Service de psychiatrie d'adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - A Schandrin
- Fondation FondaMental, Créteil, France.,Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - M Urbach
- Fondation FondaMental, Créteil, France.,Service de psychiatrie d'adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - P Vidailhet
- Fondation FondaMental, Créteil, France.,Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - G Fond
- Fondation FondaMental, Créteil, France
| | - C Dubertret
- Fondation FondaMental, Créteil, France.,AP-HP, Paris, France.,Department of Psychiatry, Service de Psychiatrie et d'Addictologie, Hôpital Louis Mourier, 178 rue des Renouillers, 92700, Colombes, France.,Inserm U894, Paris, France.,Sorbonne Paris Cité, Faculté de Médecine, Université Paris Diderot, Paris, France
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10
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Bueno-Antequera J, Oviedo-Caro MÁ, Munguía-Izquierdo D. Ideal cardiovascular health and its association with sedentary behaviour and fitness in psychiatric patients. The PsychiActive project. Nutr Metab Cardiovasc Dis 2018; 28:900-908. [PMID: 29898823 DOI: 10.1016/j.numecd.2018.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 05/02/2018] [Accepted: 05/03/2018] [Indexed: 10/14/2022]
Abstract
BACKGROUND AND AIMS Ideal cardiovascular health (CVH) was defined as meeting ideal levels of 4 health behaviours (smoking, body mass index, physical activity, and diet) and 3 biological factors (blood pressure, total cholesterol, and glucose) and is inversely related to cardiovascular disease and mortality. However, the prevalence of ideal CVH in patients with severe mental illness and the possible independent associations of sedentary behaviour and fitness with CVH score are unexplored. METHODS AND RESULTS This study included 142 (34 women) outpatients with severe mental illness (primarily schizophrenia, n = 92). CVH was evaluated according to the American Heart Association guidelines. Sedentary behaviour, cardiorespiratory fitness, and muscular strength were measured by an activity-monitor, the 6-min walk test, and handgrip dynamometry. Cardiorespiratory fitness and strength values were combined in a composite fitness score. The prevalence of ideal CVH was: non-smoking (47.9%), body mass index (16.9), physical activity (83.1%), diet (10.4%), blood pressure (40.4%), total cholesterol (62.9%), and plasma glucose (66.7%). Low levels of sedentary behaviour and high cardiorespiratory, strength, and composite fitness score were associated with meeting the ideal threshold in most CVH metrics and having higher global CVH score; however, only cardiorespiratory and composite fitness score remained significantly related to global CVH score independent of sedentary behaviour and multiple confounders. CONCLUSIONS Patients with severe mental illness generally have low prevalence of ideal CVH metrics, especially diet and body mass index. Additionally, our findings suggest the need or considering cardiorespiratory fitness, regardless of sedentary behaviour, to promote ideal CVH in this population.
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Affiliation(s)
- J Bueno-Antequera
- Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, ES-41013 Seville, Spain.
| | - M Á Oviedo-Caro
- Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, ES-41013 Seville, Spain
| | - D Munguía-Izquierdo
- Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, ES-41013 Seville, Spain; Biomedical Research Networking Center on Frailty and Healthy Aging, Madrid, Spain
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11
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Theng YM, Wahab S, Wahab NAA, Sidi H, Das S. Schizophrenia and Nicotine Dependence: What Psychopharmacological Treatment Options are Available for the Duo Perturbationes? Curr Drug Targets 2017; 20:173-181. [PMID: 29046149 DOI: 10.2174/1389450118666171017163741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 09/27/2017] [Accepted: 10/12/2017] [Indexed: 11/22/2022]
Abstract
Nicotine dependence has progressively become a foremost community health interest in both the developed and developing nations due to the economic burden and health-related problems. Smoking was significantly higher among patients with schizophrenia in comparison to the general population. Nicotine dependence is not only associated with public stress, but among patients with schizophrenia, smoking brings major challenges to the management. Nicotine may diminish the therapeutic efficacy of the bioavailability of the psychopharmacological agents in-vivo. These duo perturbations, i.e. two clinical conditions co-existed may prevent psychotic symptoms remission among patients suffering from schizophrenia who smoke at the same time. The aim of this review was to highlight the role of pharmacological treatment options and strategies for patients with nicotine dependence in schizophrenia with emphasis on the underlying neurobiological process. The role of nicotine replacement therapy, i.e. norepinephrine-dopamine reuptake inhibition (NDRI) e.g. bupropion and selective partial agonist of α4β2 and full α7-nicotinic acetylcholine receptor e.g. varenicline was deliberated. An ideal choice of drug targets for patients with schizophrenia with nicotine dependence is pivotal to foster a better therapeutic alliance.
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Affiliation(s)
- Yoong Mei Theng
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Suzaily Wahab
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Noor Alaudin A Wahab
- Audiology Programme, School of Rehabilitation Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Wilayah Persekutuan, Malaysia
| | - Hatta Sidi
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Srijit Das
- Department of Anatomy, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia
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12
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Rey R, D'Amato T, Boyer L, Brunel L, Aouizerate B, Berna F, Capdevielle D, Chereau I, Chesnoy-Servanin G, Denizot H, Dorey JM, Dubertret C, Dubreucq J, Faget C, Gabayet F, Lancon C, Mallet J, Misdrahi D, Passerieux C, Schandrin A, Schürhoff F, Urbach M, Vidailhet P, Llorca PM, Fond G. Nicotine dependence is associated with depression and childhood trauma in smokers with schizophrenia: results from the FACE-SZ dataset. Eur Arch Psychiatry Clin Neurosci 2017; 267:567-577. [PMID: 28389889 DOI: 10.1007/s00406-017-0779-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 03/06/2017] [Indexed: 12/27/2022]
Abstract
In a perspective of personalized care for smoking cessation, a better clinical characterization of smokers with schizophrenia (SZ) is needed. The objective of this study was to determine the clinical characteristics of SZ smokers with severe nicotine (NIC) dependence. 240 stabilized community-dwelling SZ smokers (mean age = 31.9 years, 80.4% male gender) were consecutively included in the network of the FondaMental Expert Centers for Schizophrenia and assessed with validated scales. Severe NIC dependence was defined by a Fagerstrom questionnaire score ≥ 7. Depression was defined by a Calgary score ≥ 6. Childhood trauma was self-reported by the Childhood Trauma Questionnaire score (CTQ). Ongoing psychotropic treatment was recorded. Severe NIC dependence was identified in 83 subjects (34.6%), depression in 60 (26.3%). 44 (22.3%) subjects were treated by antidepressants. In a multivariate model, severe NIC dependence remained associated with depression (OR = 3.2, p = 0.006), male gender (OR = 4.5, p = 0.009) and more slightly with childhood trauma (OR = 1.03, p = 0.044), independently of socio-demographic characteristics, psychotic symptoms severity, psychotropic treatments and alcohol disorder. NIC dependence was independently and strongly associated with, respectively, depression and male gender in schizophrenia, and only slightly with history of childhood trauma. Based on these results, the care of both nicotine dependence and depression should be evaluated for an effective smoking cessation intervention in schizophrenia.
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Affiliation(s)
- Romain Rey
- Fondation FondaMental, Créteil, France.
- INSERM U1028, CNRS UMR5292, Université Claude Bernard Lyon 1, Centre de Recherche en Neurosciences de Lyon, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678 Bron Cedex, France.
| | - Thierry D'Amato
- Fondation FondaMental, Créteil, France
- INSERM U1028, CNRS UMR5292, Université Claude Bernard Lyon 1, Centre de Recherche en Neurosciences de Lyon, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678 Bron Cedex, France
| | - Laurent Boyer
- Fondation FondaMental, Créteil, France
- Pôle Psychiatrie Universitaire, CHU Sainte-Marguerite, F-13274, Marseille cedex 09, France
| | - Lore Brunel
- Fondation FondaMental, Créteil, France
- INSERM U955, équipe de psychiatrie translationnelle, Créteil, France, Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, 40 rue de Mesly, F-94010, Créteil, France
| | - Bruno Aouizerate
- Fondation FondaMental, Créteil, France
- Centre Hospitalier Charles Perrens, F-33076 Bordeaux, France, Université de Bordeaux, Inserm, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, F-33000, Bordeaux, France
| | - Fabrice Berna
- Fondation FondaMental, Créteil, France
- Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Delphine Capdevielle
- Fondation FondaMental, Créteil, France
- Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - Isabelle Chereau
- Fondation FondaMental, Créteil, France
- CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003, Clermont-Ferrand Cedex 1, France
| | - Gabrielle Chesnoy-Servanin
- Fondation FondaMental, Créteil, France
- INSERM U1028, CNRS UMR5292, Université Claude Bernard Lyon 1, Centre de Recherche en Neurosciences de Lyon, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678 Bron Cedex, France
| | - Hélène Denizot
- Fondation FondaMental, Créteil, France
- CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003, Clermont-Ferrand Cedex 1, France
| | - Jean-Michel Dorey
- Fondation FondaMental, Créteil, France
- INSERM U1028, CNRS UMR5292, Université Claude Bernard Lyon 1, Centre de Recherche en Neurosciences de Lyon, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678 Bron Cedex, France
| | - Caroline Dubertret
- Fondation FondaMental, Créteil, France
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, France
| | - Julien Dubreucq
- Fondation FondaMental, Créteil, France
- Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - Catherine Faget
- Fondation FondaMental, Créteil, France
- Assistance Publique des Hôpitaux de Marseille (AP-HM), pôle universitaire de psychiatrie, Marseille, France
| | - Franck Gabayet
- Fondation FondaMental, Créteil, France
- Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - Christophe Lancon
- Fondation FondaMental, Créteil, France
- Assistance Publique des Hôpitaux de Marseille (AP-HM), pôle universitaire de psychiatrie, Marseille, France
| | - Jasmina Mallet
- Fondation FondaMental, Créteil, France
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, France
| | - David Misdrahi
- Fondation FondaMental, Créteil, France
- Centre Hospitalier Charles Perrens, F-33076 Bordeaux, France, Université de Bordeaux, CNRS UMR 5287-INCIA, Bordeaux, France
| | - Christine Passerieux
- Fondation FondaMental, Créteil, France
- Service de psychiatrie d'adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - Aurélie Schandrin
- Fondation FondaMental, Créteil, France
- Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - Franck Schürhoff
- Fondation FondaMental, Créteil, France
- INSERM U955, équipe de psychiatrie translationnelle, Créteil, France, Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, 40 rue de Mesly, F-94010, Créteil, France
| | - Mathieu Urbach
- Fondation FondaMental, Créteil, France
- Service de psychiatrie d'adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - Pierre Vidailhet
- Fondation FondaMental, Créteil, France
- Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Pierre-Michel Llorca
- Fondation FondaMental, Créteil, France
- CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003, Clermont-Ferrand Cedex 1, France
| | - Guillaume Fond
- Fondation FondaMental, Créteil, France
- Clinique Jeanne D'Arc-Hôpital Privé Parisien, Saint Mandé, F94000, France, CHU Carémeau, Nîmes, F30000, France
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13
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The challenge of reducing smoking in people with serious mental illness. THE LANCET RESPIRATORY MEDICINE 2016; 4:835-844. [DOI: 10.1016/s2213-2600(16)30228-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 07/18/2016] [Accepted: 07/19/2016] [Indexed: 12/28/2022]
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14
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Role of the Neuregulin Signaling Pathway in Nicotine Dependence and Co-morbid Disorders. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2015; 124:113-31. [PMID: 26472527 DOI: 10.1016/bs.irn.2015.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Smoking is currently the leading cause of preventable death in the United States and is responsible for over four million deaths annually worldwide. Therefore, there is a vast clinical unmet need with regards to therapeutics targeting smoking cessation. This is even more apparent when examining smokers co-morbid with psychiatric illness, as rates of smoking in this population are ~4× higher than in the general population. Examining common genetic and molecular signaling pathways impinging upon both smoking behavior and psychiatric illness will lead to a better understanding of co-morbid disorders and potential development of novel therapeutics. Studies have implicated the Neuregulin Signaling Pathway in the pathophysiology of a number of psychiatric illnesses. Additionally, recent studies have also shown an association between the Neuregulin Signaling Pathway and smoking behaviors. This review outlines basic mechanisms of the Neuregulin Signaling Pathway and how it may be exploited for precision medicine approaches in treating nicotine dependence and mental illness.
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15
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The effect of nicotine dependence on psychopathology in patients with schizophrenia. BIOMED RESEARCH INTERNATIONAL 2015; 2015:730291. [PMID: 26060820 PMCID: PMC4427765 DOI: 10.1155/2015/730291] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 10/07/2014] [Accepted: 10/08/2014] [Indexed: 11/17/2022]
Abstract
Introduction. Our study aims to determine the prevalence of nicotine dependence and investigate the effect of nicotine dependence on psychopathology among schizophrenia patients. Methods. A cross-sectional study was carried out in an outpatient psychiatric clinic at a general hospital in Malaysia. 180 recruited subjects were administered the Malay version of Mini International Neuropsychiatric Interview (MINI), the Positive and Negative Symptom Scale (PANSS), and the Malay version of Fagerstrom Test for Nicotine Dependence (FTND-M) questionnaires. Results. The prevalence of nicotine dependence among the subjects was 38.1% (n = 69) and they were mainly composed of male gender, Malay ethnicity, being treated with atypical antipsychotics, and taking other illicit drugs or alcohol. Subjects with severe nicotine dependence scored less in the negative subscale of PANSS compared with the nonsmokers (P = 0.011). On performing the hierarchy multiple regressions, dependence status still significantly predicted negative scores after adjusting the confounders (t = −2.87, P = 0.005). Conclusion. The rate of nicotine use disorder among schizophrenia patients in this study is higher than that of the general population in Malaysia. The significant association between nicotine dependence and negative psychopathology symptoms will help the healthcare practitioners in their management of nicotine dependence among schizophrenia patients.
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16
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Manzella F, Maloney SE, Taylor GT. Smoking in schizophrenic patients: A critique of the self-medication hypothesis. World J Psychiatry 2015; 5:35-46. [PMID: 25815253 PMCID: PMC4369547 DOI: 10.5498/wjp.v5.i1.35] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 11/27/2014] [Accepted: 01/12/2015] [Indexed: 02/05/2023] Open
Abstract
A common remark among laypeople, and notably also among mental health workers, is that individuals with mental illnesses use drugs as self-medication to allay clinical symptoms and the side effects of drug treatments. Roots of the self-medication concept in psychiatry date back at least to the 1980s. Observations that rates of smokers in schizophrenic patients are multiple times the rates for regular smoking in the general population, as well as those with other disorders, proved particularly tempting for a self-medication explanation. Additional evidence came from experiments with animal models exposed to nicotine and the identification of neurobiological mechanisms suggesting self-medication with smoking is a plausible idea. More recently, results from studies comparing smoking and non-smoking schizophrenic patients have led to the questioning of the self-medication hypothesis. Closer examination of the literature points to the possibility that smoking is less beneficial on schizophrenic symptomology than generally assumed while clearly increasing the risk of cancer and other smoking-related diseases responsible for early mortality. It is a good time to examine the evidence for the self-medication concept as it relates to smoking. Our approach is to focus on data addressing direct or implied predictions of the hypothesis in schizophrenic smokers.
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17
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Grant LG, Oliffe JL, Johnson JL, Bottorff JL. Health care professionals implementing a smoke-free policy at inpatient psychiatric units. QUALITATIVE HEALTH RESEARCH 2014; 24:1732-1744. [PMID: 25216860 DOI: 10.1177/1049732314549026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Smoke-free grounds policies (SFGPs) were introduced to inpatient psychiatric hospital settings to improve health among patients, staff, and visitors. We conducted an ethnographic study in Northern British Columbia, Canada, to describe how the implementation of SFGPs is affected by institutional cultures. Data reported here included participant observation, document review, informal discussions (n = 11), and interviews with health care professionals (HCPs; n = 19) and staff (n = 2) at two hospitals. We used iterative and inductive processes to derive thematic findings. Findings related to HCPs illustrate how local contexts and cultural factors affect SFGP implementation. These factors included individual beliefs and attitudes, the influence of group norms, leadership and consensus building, and locale-specific norms. Strong, consultative leadership, in which leaders solicited input from and long-term support of people most directly responsible for policy implementation, was key to success.
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Affiliation(s)
- Lyle G Grant
- Saskatchewan Institute of Applied Science and Technology, Saskatoon, Saskatchewan, Canada
| | - John L Oliffe
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Joy L Johnson
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Joan L Bottorff
- University of British Columbia, Okanagan Campus, Kelowna, British Columbia, Canada
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18
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Pyszczynski AD, Shahan TA. Examination of the role of dopamine D₂ and adrenergic α₂ receptors in resurgence of food seeking. Behav Brain Res 2014; 271:122-8. [PMID: 24914462 DOI: 10.1016/j.bbr.2014.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 06/02/2014] [Indexed: 12/28/2022]
Abstract
Resurgence refers to the reappearance of an extinguished operant behavior when reinforcement for an alternative behavior is also subsequently discontinued. Resurgence has been noted as a source of relapse to problem behavior following interventions involving alternative reinforcement, and has also been recently used as an animal model of relapse to drug seeking induced by reinforcement loss. Existing information about the neuropharmacology of resurgence is scarce, but suggests overlap between relapse observed in the resurgence model and relapse observed in reinstatement and renewal models. In the present experiment rats earned food pellets for pressing a target lever in Phase I. In Phase II lever pressing no longer produced food, but food was delivered for an alterative nose poke response. Finally in Phase III, neither response produced food deliveries. Prior to these Phase III sessions, separate groups of rats were injected with 0, 50, or 100 μg/kg of the dopamine D2 receptor antagonist raclopride or 0, 20, or 40 μg/kg of α 2 agonist clonidine. Both doses of raclopride were effective in blocking resurgence, but there was evidence that the higher dose did so via motor rather than motivational impairment. Only the higher dose of clonidine blocked resurgence, but did so with no evidence of motor impairment. Raclopride significantly impacted extinction of the alternative poke at both doses tested, whereas clonidine had no effect at either dose. The results of the present study provide additional information about the neuropharmacology of resurgence, as well as additional evidence of overlap between resurgence, reinstatement, and renewal.
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Affiliation(s)
- Adam D Pyszczynski
- Department of Psychology, Utah State University, 2810 Old Main Hill, Logan, UT 84322, USA
| | - Timothy A Shahan
- Department of Psychology, Utah State University, 2810 Old Main Hill, Logan, UT 84322, USA.
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Lohner S, Vágási J, Marosvölgyi T, Tényi T, Decsi T. Inverse association between 18-carbon trans fatty acids and intelligence quotients in smoking schizophrenia patients. Psychiatry Res 2014; 215:9-13. [PMID: 24210662 DOI: 10.1016/j.psychres.2013.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 09/29/2013] [Accepted: 10/16/2013] [Indexed: 11/17/2022]
Abstract
This study aimed to investigate polyunsaturated (PUFA) and trans isomeric fatty acid status in schizophrenia patients. Fatty acid composition of plasma phospholipids (PL) and triacylglycerols (TG) was analyzed by gas chromatography in 29 schizophrenia patients and 15 healthy controls. We found no difference in PL n-3 fatty acid status between the two groups, while the values of 22:5n-6 were significantly higher in patients with schizophrenia than in controls. In TG, values of docosatrienoic acid (20:3n-3) and docosapentaenoic acid (20:5n-3) were significantly higher in schizophrenia patients than in controls. We found no difference in the trans fatty acid status between patients and controls. In smoking schizophrenia patients significant negative correlations were detected between Wechsler adult full-scale intelligence quotients and values of total trans fatty acids in PL lipids, whereas no such correlation was seen either in non-smoking schizophrenia patients, or in healthy controls. While data obtained in the present study fail to furnish evidence for n-3 PUFA supplementation to the diet of patients with schizophrenia, they indicate that in smoking schizophrenia patients high dietary exposure to trans fatty acids is associated with lower intelligence quotients.
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Affiliation(s)
- Szimonetta Lohner
- Department of Pediatrics, University of Pécs, József A. u. 7, H-7623 Pécs, Hungary.
| | - Judit Vágási
- Department of Pediatrics, University of Pécs, József A. u. 7, H-7623 Pécs, Hungary
| | - Tamás Marosvölgyi
- Department of Pediatrics, University of Pécs, József A. u. 7, H-7623 Pécs, Hungary
| | - Tamás Tényi
- Department of Psychiatry and Psychotherapy, University of Pécs, Pécs, Hungary
| | - Tamás Decsi
- Department of Pediatrics, University of Pécs, József A. u. 7, H-7623 Pécs, Hungary
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Drobes DJ, MacQueen DA, Blank MD, Saladin ME, Malcolm RJ. Effects of intravenous nicotine on prepulse inhibition in smokers and non-smokers: relationship with familial smoking. Psychopharmacology (Berl) 2013; 229:285-94. [PMID: 23624809 PMCID: PMC3758468 DOI: 10.1007/s00213-013-3107-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 04/03/2013] [Indexed: 11/26/2022]
Abstract
RATIONALE The reinforcing properties of nicotine may be, in part, derived from its ability to enhance certain forms of cognitive processing. Several animal and human studies have shown that nicotine increases prepulse inhibition (PPI) of the startle reflex. However, it remains unclear whether these effects are related to smoking susceptibility. OBJECTIVES The current study examined the effects of intravenously delivered nicotine on PPI in smokers and non-smokers, as well as its association with a quantitative index of familial smoking. METHODS The sample consisted of 30 non-smokers and 16 smokers, who completed an initial assessment, followed on a separate day by a laboratory assessment of PPI prior to and following each of two intravenous nicotine infusions. Separate doses were used in smoker and non-smoker samples. RESULTS Analyses indicated that both nicotine infusions acutely enhanced PPI among non-smokers, and this enhancement was positively related to the degree of smoking among first and second-degree relatives. Smokers also displayed PPI enhancement after receiving the first infusion, but this effect was unrelated to familial smoking. CONCLUSIONS These data suggest that the PPI paradigm may have utility as an endophenotype for cognitive processes which contribute to smoking risk.
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Affiliation(s)
- David J Drobes
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, University of South Florida, Tampa, FL, USA.
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Do atypical antipsychotics really enhance smoking reduction more than typical ones?: the effects of antipsychotics on smoking reduction in patients with schizophrenia. J Clin Psychopharmacol 2013; 33:319-28. [PMID: 23609378 DOI: 10.1097/jcp.0b013e31828b2575] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Whether atypical antipsychotics (AAs) can enhance smoking reduction in schizophrenic patients remains controversial because of methodological limitations in existing studies. This study explored whether certain types of antipsychotics predict smoking reduction in schizophrenic patients. Three hundred eight smoking, predominantly male schizophrenic patients (271/308 [88.9%]) participated in an 8-week open-label study with antismoking medications (high-dose, low-dose nicotine transdermal patch and bupropion). Antipsychotics were classified into (1) typical antipsychotics (TAs) and (2) AAs, including multiacting receptor-targeted antipsychotics (clozapine, olanzapine, and quetiapine), serotonin-dopamine antagonists (risperidone), D2/D3 receptor antagonists (amisulpride), and partial dopamine receptor agonists (aripiprazole). A general linear model was used to explore whether types of antipsychotic predict changes in the number of cigarettes smoked per day (CPD) and the score of the Fagerstrom Test for Nicotine Dependence (FTND) while controlling for confounding factors. The type of antipsychotic (TAs or AAs) was not significantly associated with smoking cessation (n = 21; χ = 1.8; df = 4; P = 0.77). Regarding smoking reduction, the type of antipsychotic was significantly predictive of a change in the CPD (P = 0.027; partial eta square = 0.055) and FTND scores (P = 0.002; partial eta square = 0.073). The 95% confidence intervals of the estimated means of change in the CPD and FTND scores did not contain zero only among subjects on TAs or clozapine.These findings suggest that TAs and clozapine enhance smoking reduction compared with nonclozapine atypical antipsychotics in schizophrenic patients. The mechanisms underlying the effects of various antipsychotics on smoking reduction remain unclear and warrant future study.
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Grayson DR, Guidotti A. The dynamics of DNA methylation in schizophrenia and related psychiatric disorders. Neuropsychopharmacology 2013; 38:138-66. [PMID: 22948975 PMCID: PMC3521968 DOI: 10.1038/npp.2012.125] [Citation(s) in RCA: 196] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Revised: 05/08/2012] [Accepted: 05/09/2012] [Indexed: 02/06/2023]
Abstract
Major psychiatric disorders such as schizophrenia (SZ) and bipolar disorder (BP) with psychosis (BP+) express a complex symptomatology characterized by positive symptoms, negative symptoms, and cognitive impairment. Postmortem studies of human SZ and BP+ brains show considerable alterations in the transcriptome of a variety of cortical structures, including multiple mRNAs that are downregulated in both inhibitory GABAergic and excitatory pyramidal neurons compared with non-psychiatric subjects (NPS). Several reports show increased expression of DNA methyltransferases in telencephalic GABAergic neurons. Accumulating evidence suggests a critical role for altered DNA methylation processes in the pathogenesis of SZ and related psychiatric disorders. The establishment and maintenance of CpG site methylation is essential during central nervous system differentiation and this methylation has been implicated in synaptic plasticity, learning, and memory. Atypical hypermethylation of candidate gene promoters expressed in GABAergic neurons is associated with transcriptional downregulation of the corresponding mRNAs, including glutamic acid decarboxylase 67 (GAD67) and reelin (RELN). Recent reports indicate that the methylation status of promoter proximal CpG dinucleotides is in a dynamic balance between DNA methylation and DNA hydroxymethylation. Hydroxymethylation and subsequent DNA demethylation is more complex and involves additional proteins downstream of 5-hydroxymethylcytosine, including members of the base excision repair (BER) pathway. Recent advances in our understanding of altered CpG methylation, hydroxymethylation, and active DNA demethylation provide a framework for the identification of new targets, which may be exploited for the pharmacological intervention of the psychosis associated with SZ and possibly BP+.
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Affiliation(s)
- Dennis R Grayson
- The Psychiatric Institute, Department of Psychiatry, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA.
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Moran VE. Cotinine: Beyond that Expected, More than a Biomarker of Tobacco Consumption. Front Pharmacol 2012; 3:173. [PMID: 23087643 PMCID: PMC3467453 DOI: 10.3389/fphar.2012.00173] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Accepted: 09/10/2012] [Indexed: 12/15/2022] Open
Abstract
A greater incidence of tobacco consumption occurs among individuals with psychiatric conditions including post-traumatic stress disorder (PTSD), bipolar disorder, major depression, and schizophrenia, compared with the general population. Even when still controversial, it has been postulated that smoking is a form of self-medication that reduces psychiatric symptoms among individuals with these disorders. To better understand the component(s) of tobacco-inducing smoking behavior, greater attention has been directed toward nicotine. However, in recent years, new evidence has shown that cotinine, the main metabolite of nicotine, exhibits beneficial effects over psychiatric symptoms and may therefore promote smoking within this population. Some of the behavioral effects of cotinine compared to nicotine are discussed here. Cotinine, which accumulates in the body as a result of tobacco exposure, crosses the blood-brain barrier and has different pharmacological properties compared with nicotine. Cotinine has a longer plasma half-life than nicotine and showed no addictive or cardiovascular effects in humans. In addition, at the preclinical level, cotinine facilitated the extinction of fear memory and anxiety after fear conditioning, improved working memory in a mouse model of Alzheimer’s disease (AD) and in a monkey model of schizophrenia. Altogether, the new evidence suggests that the pharmacological and behavioral effects of cotinine may play a key role in promoting tobacco smoking in individuals that suffer from psychiatric conditions and represents a new potential therapeutic agent against psychiatric conditions such as AD and PTSD.
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Affiliation(s)
- Valentina Echeverria Moran
- Research and Development, Department of Veterans Affairs, Bay Pines VA Healthcare System Bay Pines, FL, USA ; Tampa VA Healthcare System Tampa, FL, USA ; Department of Molecular Medicine, University of South Florida Tampa, FL, USA
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Krishnadas R, Jauhar S, Telfer S, Shivashankar S, McCreadie RG. Nicotine dependence and illness severity in schizophrenia. Br J Psychiatry 2012; 201:306-12. [PMID: 22878134 DOI: 10.1192/bjp.bp.111.107953] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Reasons for the increased prevalence of cigarette smoking in schizophrenia are unclear. Studies assessing clinical symptoms have sampled heterogeneous populations, with discrepant findings. AIMS To examine the relationship between clinical features, social adjustment and nicotine dependence in a geographically defined population of people with schizophrenia. METHOD Cross-sectional clinical study of 131 people with schizophrenia in Nithsdale, Scotland. RESULTS Smokers were younger, mostly males and three times more likely to be unemployed. Those with severe nicotine dependence had greater scores on the positive subscale of the Positive and Negative Syndrome Scale (PANSS), and were prescribed higher doses of antipsychotic. Those with mild-moderate dependence had greater scores on the PANSS negative subscale. Greater symptom severity was associated with poorer social adjustment. Psychopathology and social adjustment were similar in quitters and never-smokers. CONCLUSIONS Our findings indicate an association between nicotine dependence, clinical symptoms and social adjustment in schizophrenia. Although causal links cannot be inferred, identifying the relationship between nicotine dependence and psychopathology may have some value in the management of smoking in schizophrenia. Further longitudinal studies are required to explore this relationship.
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Affiliation(s)
- Rajeev Krishnadas
- Sackler Institute of Psychobiological Research, University of Glasgow, Southern General Hospital, Glasgow G51 4TF, UK.
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Liester MB, Prickett JI. Hypotheses Regarding the Mechanisms of Ayahuasca in the Treatment of Addictions. J Psychoactive Drugs 2012; 44:200-8. [DOI: 10.1080/02791072.2012.704590] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Different impacts of aquaporin 4 and MAOA allele variation among olanzapine, risperidone, and paliperidone in schizophrenia. J Clin Psychopharmacol 2012; 32:394-7. [PMID: 22544010 DOI: 10.1097/jcp.0b013e31825370f4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Apoptosis has been considered to be involved in schizophrenia. Water channels are modulated just before apoptosis. In the aquaporin family, aquaporin 4 (AQP-4) is most highly expressed in the brain and is supposed to play an important role in a neuronal environment. In this clinical study, we investigated the relationship between the AQP-4 polymorphism and drug response in schizophrenia under the control of the MAOA (monoamine oxidase A) promoter gene. We recruited 91 patients with schizophrenia, and they were randomized to receive olanzapine (n = 44), risperidone (n = 23), or paliperidone (n = 24). Genotyping of AQP-4 and MAOA polymorphisms was done in all patients. Patients with the AQP-4 non-C polymorphism needed a higher dosage of olanzapine for treatment (z = 4.163, P = 0.041), and patients with a short form of the MAOA polymorphism needed a higher dosage of risperidone for treatment (z = 5.124, P = 0.024). Patients who smoked cigarettes needed a higher dosage of olanzapine for treatment (z = 4.905, P = 0.027), but cigarette smoking did not affect the dosage of paliperidone. The AQP-4 polymorphism may have an effect in influencing the dosage of olanzapine. However, the roles of AQP-4 polymorphisms in the blood-brain barrier and different neuroprotective effects need further exploration in future studies.
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Abstract
BACKGROUND It is well established that persons with schizophrenia have high mortality rates. There is conflicting evidence that antipsychotic and perhaps other medications routinely used to treat schizophrenia contribute to mortality risk. METHODS A health insurer database was used to examine schizophrenia diagnosis and mortality in 2008. Information from the period 2006-2008 was used to analyze demographics and medication prescriptions. The risk set composed of patients with schizophrenia using an antipsychotic (n = 7415) and a group of randomly chosen control subjects (n = 97,726). RESULTS The mortality risk for having a diagnosis of schizophrenia and using an antipsychotic versus the random control group was a hazard ratio (HR) of 2.6; 95% CI, 2.0-3.2. Over the 3-year period, age, receiving a first-generation antipsychotic, and the use of a mood stabilizer were associated with a higher risk of mortality: HR, 1.06; 95% CI, 1.04-1.08; HR, 2.36; 95% CI, 1.38-4.04; and HR, 8.42; 95% CI, 3.06-24.07, respectively. CONCLUSION Patients with schizophrenia have higher mortality rates than normal controls. The type of antipsychotic and concomitant medication can affect mortality rates in schizophrenia.
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