Shimoda Kazutaka
Department of Psychiatry, Dokkyo University School of Medicine, 880, Kitakobayashi, Mibu, Tochigi 321-0293, Japan.
Nihon Shinkei Seishin Yakurigaku Zasshi. 2004 Apr;24(2):67-70.
The population of Japanese smokers has decreased; however, the prevalence of smokers among psychiatric patients has been reported to be as high as 80% in schizophrenic patients. Although the impact of smoking on the pharmacokinetics of antipsychotics has been reported, results have been controversial. At first, the impact of smoking on plasma haloperidol (HAL) concentrations was investigated in Japanese male schizophrenic inpatients treated with HAL per os. Smokers had approximately 20% lower HAL concentrations/daily dose of HAL/kg body weight than non-smokers. The impact of genetic polymorphism of CYP1A2 that are related to the induction of the isozyme on the plasma levels of HAL in male smokers with schizophrenia was also investigated. A point mutation from C to A in intron 1 at position 734 and a point mutation from G to A at position--2964 in the 5'-flanking region of CYP1A2 were identified by the PCR-RFLP method. Regarding C/A polymorphism in intron 1 at position 734, no significant difference was found in the plasma concentrations of HAL corrected for dose and weight among the subjects with A/A, A/C and C/C genotypes. Regarding G/A polymorphism at position--2964 in the 5'-flanking region, no significant difference was found in the plasma concentrations of HAL corrected for dose and weight between subjects with G/G and G/A.
日本吸烟人群数量有所减少;然而,据报道,在精神科患者中,精神分裂症患者的吸烟率高达80%。尽管已有报道称吸烟会对抗精神病药物的药代动力学产生影响,但其结果仍存在争议。首先,对口服氟哌啶醇治疗的日本男性精神分裂症住院患者进行了吸烟对血浆氟哌啶醇(HAL)浓度影响的研究。吸烟者的HAL浓度/每日剂量的HAL/千克体重比不吸烟者低约20%。还研究了与该同工酶诱导相关的CYP1A2基因多态性对男性精神分裂症吸烟者血浆中HAL水平的影响。通过PCR-RFLP方法在CYP1A2的5'-侧翼区域第734位内含子1处鉴定出从C到A的点突变以及在-2964位从G到A的点突变。关于第734位内含子1处的C/A多态性,在A/A、A/C和C/C基因型的受试者中,经剂量和体重校正后的HAL血浆浓度未发现显著差异。关于5'-侧翼区域-2964位的G/A多态性,在G/G和G/A受试者之间,经剂量和体重校正后的HAL血浆浓度未发现显著差异。