Grabowski Jakub, Bidzan Leszek, Brzozowska Aleksandra
Division of Developmental, Psychotic and Geriatric Psychiatry, Department of Psychiatry, Faculty of Medicine, Medical University of Gdańsk, 80-282 Gdańsk, Poland.
Department of Health Sciences, Pomeranian University in Słupsk, 76-200 Słupsk, Poland.
Pharmaceuticals (Basel). 2025 Sep 12;18(9):1366. doi: 10.3390/ph18091366.
: Prevalence of nicotine misuse among schizophrenia patients is significantly higher than in the general population and is estimated at 70-90%. Past studies have shown that nicotine misuse affects the course of the schizophrenic process in terms of frequency of hospitalizations, age of the first onset, social functioning, and pharmacotherapy, among others. This study aimed to examine associations between smoking and psychopathology, course of hospitalization, doses of administered antipsychotics, and severity of adverse events in men hospitalized for exacerbations of schizophrenia. : Protocol procedures were performed in 81 men (40 smokers and 41 non-smokers) and included assessments with a structured interview, laboratory tests, the Positive and Negative Syndrome Scale (PANSS), Montgomery and Asberg Depression Rating Scale (MADRS), Fagerstrom Test for Nicotine Dependence (FTND), and extrapyramidal symptom scales. : In both groups, a comparable number of patients met the criteria for remission. However, in the pre-discharge period, non-smokers had more severe depressive symptoms measured by MADRS and PANSS than smokers, as well as more severe and more frequent extrapyramidal symptoms. In contrast to previous research, significantly higher doses of antipsychotics measured in chlorpromazine equivalent (CPZE) doses were administered in non-smokers than in smokers (881.1 versus 689.3, = 0.0305). Non-smokers were also more likely to need high doses of medication (>1000 milligrams CPZE) than smokers (43.9% versus 20%, = 0.0212). However, these associations lost statistical significance after adjustment for initial severity and treatment-related factors. Comparison of CPZEs in the context of metabolic pathways suggests that variations in doses are independent of metabolism by cytochrome P450 1A2 (CYP1A2). The results also indicate that nicotine may help to differentiate between negative and depressive symptoms. : In this male inpatient sample, smokers showed lower depressive symptom scores. Although smoking may affect some symptoms of schizophrenia according to the self-medication hypothesis, therapeutic measures aimed at smoking cessation should not be delayed in this group of patients.
精神分裂症患者中尼古丁滥用的患病率显著高于普通人群，估计为70%-90%。过去的研究表明，尼古丁滥用在住院频率、首次发病年龄、社会功能和药物治疗等方面会影响精神分裂症的病程。本研究旨在探讨因精神分裂症急性加重而住院的男性患者中吸烟与精神病理学、住院病程、抗精神病药物剂量及不良事件严重程度之间的关联。对81名男性（40名吸烟者和41名非吸烟者）进行了方案程序操作，包括结构化访谈评估、实验室检查、阳性和阴性症状量表（PANSS）、蒙哥马利和阿斯伯格抑郁评定量表（MADRS）、尼古丁依赖的法格斯特龙测试（FTND）以及锥体外系症状量表评估。两组中达到缓解标准的患者数量相当。然而，在出院前阶段，非吸烟者通过MADRS和PANSS测量的抑郁症状比吸烟者更严重，锥体外系症状也更严重且更频繁。与先前的研究相反，以氯丙嗪等效剂量（CPZE）测量的非吸烟者使用的抗精神病药物剂量显著高于吸烟者（881.1对689.3，P = 0.0305）。非吸烟者也比吸烟者更有可能需要高剂量药物（>1000毫克CPZE）（43.9%对20%，P = 0.0212）。然而，在对初始严重程度和治疗相关因素进行调整后，这些关联失去了统计学意义。在代谢途径背景下对CPZE的比较表明，剂量变化与细胞色素P450 1A2（CYP1A2）的代谢无关。结果还表明，尼古丁可能有助于区分阴性和抑郁症状。在这个男性住院患者样本中，吸烟者的抑郁症状评分较低。尽管根据自我用药假说，吸烟可能会影响精神分裂症的某些症状，但针对该组患者的戒烟治疗措施不应延迟。
