Smith Robert C, Singh Abhay, Infante Mauricio, Khandat Amaresh, Kloos Angelica
Department of Psychiatry, New York University Medical School, New York, NY 11557-0316, USA.
Neuropsychopharmacology. 2002 Sep;27(3):479-97. doi: 10.1016/S0893-133X(02)00324-X.
Schizophrenic patients have among the highest rates of smoking of any group of patients. Previous studies have identified psychophysiological and potential nicotinic receptor abnormalities which may be associated with this phenomenon. The effects of acute smoking or acute administration of nicotine nasal spray, after smoking abstinence, on negative symptoms and neurocognitive function have been less extensively studied in experimental designs. This study investigated the effects of smoking of high nicotine or denicotinized cigarettes, and receiving active or placebo nicotine nasal sprays, on positive and negative symptoms and cognitive functions in schizophrenic patients. The study utilized a placebo controlled crossover experimental design with pre- and post-drug evaluations on each experimental day. Smoking high nicotine cigarettes decreased negative symptoms more than denicotinized cigarettes, but smoking neither cigarette changed scores of positive symptoms, anxiety, or depression. Active nicotine nasal spray did not differentially decrease negative symptoms compared with placebo, but did improve performance on a spatial organization task, and tended to improve some measures of verbal memory and two-choice reaction time in schizophrenic patients. Both high and denicotinized cigarettes improved performance on the spatial processing task, but there was no statistically significant differential drug (Cigarette type) effect. These results suggest that acute smoking of cigarettes may transiently decrease negative symptoms in patients with schizophrenia, but it is unclear whether this effect is attributable to nicotine, other components of cigarettes, or the act of smoking. Nicotine nasal spray may modestly improve some selected aspects of cognitive function in schizophrenia.
精神分裂症患者在所有患者群体中的吸烟率最高。先前的研究已经确定了可能与这种现象相关的心理生理和潜在的烟碱受体异常。在实验设计中，对戒烟后急性吸烟或急性给予尼古丁鼻喷雾剂对阴性症状和神经认知功能的影响研究较少。本研究调查了吸食高尼古丁香烟或去尼古丁香烟以及接受活性或安慰剂尼古丁鼻喷雾剂对精神分裂症患者阳性和阴性症状及认知功能的影响。该研究采用了安慰剂对照交叉实验设计，在每个实验日进行药物前后评估。吸食高尼古丁香烟比吸食去尼古丁香烟更能减轻阴性症状，但吸食这两种香烟均未改变阳性症状、焦虑或抑郁的评分。与安慰剂相比，活性尼古丁鼻喷雾剂在减轻阴性症状方面没有差异，但确实改善了精神分裂症患者在空间组织任务上的表现，并且倾向于改善一些言语记忆指标和双选反应时间。高尼古丁香烟和去尼古丁香烟都改善了空间处理任务的表现，但药物（香烟类型）效应在统计学上没有显著差异。这些结果表明，急性吸烟可能会暂时减轻精神分裂症患者的阴性症状，但尚不清楚这种效应是归因于尼古丁、香烟的其他成分还是吸烟行为。尼古丁鼻喷雾剂可能会适度改善精神分裂症患者认知功能的某些特定方面。
