Paroxetine binding in aggressive schizophrenic patients

European Neuropsychopharmacology, 2002

The increased rate of smoking in schizophrenia patients remains unexplained and may reflect attempts at self-treatment. The effect sought from smoking may be related to nicotine’s stimulating action. We tested this hypothesis by examining the relationship between smoking status and finger tapping rate, a measure of central processing, in schizophrenia patients treated with atypical antipsychotics. Smokers showed significantly faster finger tapping rates than non-smokers. This was not related to clinical state, illness chronicity, medication side-effects, antipsychotic dose or plasma concentrations. Nicotine can improve central processing in medicated schizophrenia patients and this may constitute part of the incentive for smoking.

Nicotine & Tobacco Research, 2010

phrenia show higher levels of nicotine and its metabolites (Strand & Nyback, 2005; Williams et al., 2005) and altered cigarette puffing (Tidey, Rohsenow, Kaplan, & Swift, 2005) despite normal rates of nicotine metabolism (Williams et al.). The increase in levels of blood nicotine from smoking a single cigarette is referred to as "nicotine boost," and there are theories about different smoking patterns and what they represent. So called, "peak seekers" who achieve a high nicotine boost may be seeking more positive reinforcement or arousal, whereas trough maintainers are suspected to smoke for reasons of negative reinforcement to avoid withdrawal (Russell & Feyerabend, 1978). Greater nicotine boost may be linked to increased addictive potential and increased risk for relapse after a quit attempt (Patterson et al., 2003). We hypothesized that smokers with schizophrenia would be more likely to be peak seekers with higher levels of nicotine boost from a single cigarette. The objective of this study was to measure venous nicotine blood levels after smoking a single cigarette in a laboratory-based design in smokers with schizophrenia and those without a current mental illness. Methods Subjects Subjects were 21 smokers (11 schizophrenia, SCZ and 10 controls, CON) who also participated in a larger ongoing study of nicotine levels and smoking topography. Smokers were recruited sequentially if they smoked 20-30 cigarettes/day of a regular (no light or ultra-light) brand of cigarettes. All participants gave signed informed consent. The Institutional Review Board of Robert Wood Johnson Medical School approved the protocol. All subjects with schizophrenia were enrolled in mental health treatment, stable on antipsychotic medications, and had their diagnosis confirmed with the Structured Clinical Interview for DSM-IV (Spitzer & Williams, 1985). Individuals with schizoaffective disorder or serious cognitive impairment were excluded.

Psychiatry Research, 2004

The role of personality in nicotine use has been little studied in patients with schizophrenia. The objectives of the present study were to compare impulsivity, sensation seeking and anhedonia in a group of schizophrenic patients with and without current cigarette smoking. One hundred patients with schizophrenia or schizoaffective disorder (DSM-III-R criteria) were assessed with the Positive and Negative Syndrome Scale, the Fagerström Scale, the Barratt Impulsivity Scale, the Zuckerman Seeking Sensation Scale, and the Chapman Physical Anhedonia Scale. Among these patients, 67% were current smokers. The mean scores for sensation seeking were higher in the group of smokers than in the group of nonsmokers. The differences were found exclusively with the ''disinhibition'' subscale. No significant difference was found for impulsivity and physical anhedonia mean scores. The scores on the Sensation Seeking Scale were especially low in nonsmokers. Cigarette smoking could influence disinhibition and possibly help to normalize inhibition in schizophrenic patients.

Psychiatry Research, 2011

Although an acute effect of cigarette smoking and nicotine on sensory gating of schizophrenias has been investigated in published papers, the chronic effect of cigarette smoking on this phenomenon has not yet been reported. We report the effects of chronic cigarette smoking, without new acute exposure before testing, on sensory gating using the P50 auditory evoked potential in a group of drug-naive first episode schizophrenic smokers and healthy smokers. Sensory gating was evaluated using auditory P50 suppression elicited using the conditioning (S1)-testing (S2) paradigm. Fifty six male drug-naive first episode schizophrenic patients were compared to 41 healthy male controls. Patients were classified into subgroups of current smokers (n=18) and non-smokers (n=38) to explore the effects of smoking on sensory gating. All subjects did not smoke a cigarette for at least 1h prior to testing. Schizophrenic patients showed an increased S2 amplitude and a poorer sensory gating as measured by both S2/S1 ratio and S1-S2 difference of P50 amplitude, as compared to healthy controls. However, smokers showed an increased S1 amplitude and better sensory gating than did non-smokers both in schizophrenia patients and healthy controls. Our findings support a sensory gating deficit among first episode schizophrenic patients. However, it was less pronounced among schizophrenic patients who were current cigarette smokers, suggesting a positive effect of chronic cigarette smoking on ameliorating this sensory gating deficit in schizophrenia. Our findings of the present study present new evidence supporting the self-medication hypothesis of self-medication by cigarette smoking in schizophrenia to possibly ameliorate pre-existing functional deficits.

Neuropsychopharmacology, 2002

We investigated the effect of nicotine on three behavioral markers of risk for schizophrenia: sustained attention (using the Continuous Performance Task (CPT)), antisaccade performance, and smooth pursuit. Smooth pursuit was investigated in two conditions, one in which attention was enhanced (monitoring target changes) and one in which attention was not enhanced (no monitoring). Patients with schizophrenia (n ϭ 15) and controls (n ϭ 14) were given a 14-mg nicotine patch in a double-blind, placebo-controlled, crossover design and plasma nicotine concentrations were monitored. Nicotine concentrations were similar in both groups. A Group ϫ Drug interaction ( p Ͻ .02) on CPT hits indicated that nicotine improved sustained attention in patients but not in controls. Nicotine significantly decreased antisaccade errors ( p Ͻ .01) in both groups. A Drug ϫ Monitoring condition interaction ( p Ͻ .01) on pursuit gain indicated that nicotine significantly increased pursuit gain in the no-monitoring condition in patients and controls equally, but did not improve pursuit in the monitoring condition. Thus, improvement in pursuit may have been mediated via an effect on attention rather than by an effect on oculomotor function per se. In patients, the magnitude of improvement in attention on nicotine was correlated with the improvement on eye movement tasks. Thus, nicotine improves performance on both attention and oculomotor markers of risk for schizophrenia, possibly via common mechanisms.

Schizophrenia Bulletin, 2011

The management of aggression in patients with schizophrenia is a complex and challenging clinical dilemma. It also is greatly influenced by prevailing societal and medicolegal considerations regarding the perceived associations between violence and mental illness. This article provides a succinct account of a complex area and offers evidence for available treatments to reduce the occurrence of violent behavior among patients with schizophrenia.

Trends journal of sciences research, 2018

To examine which medication could lead to a higher short and long term smoking abstinence in patients with schizophrenia. Methods: A retrospective cohort study was conducted using General Electric (GE) medical records database (1995-2011). The cohort consisted of adult smokers with diagnosis of schizophrenia newly initiating cessation medication. Short term and long term outcomes of cessation were measured at 3 weeks and 1 year. Descriptive and chi-square analyses were used to determine the frequencies and associations of patient characteristics with the abstinence outcomes. Logistic regression models were carried out to determine the predictors of short term and long term abstinence. Results: The cohort consisted of 3,976 patients. Abstinence rate was highest for Varenicline, followed by Bupropion, NRT, and lastly combination at week 12. At one year, abstinence rate was highest for Varenicline, followed by combination, NRT, and lastly Bupropion. Age, race, household locations and receiving counseling were associated with abstinence. No significant differences were found between cessation medications. Conclusions: There were no statistically significant differences in quitting with type of cessation medication. Predictors of better abstinence identified included older age, white race, western household location. These factors should be considered when designing future interventions for schizophrenic population as this minority population may need more tailored approaches to achieve a successful cessation outcome.

Schizophrenia …, 1997

Objective: The effect of smoking on daily doses and plasma levels of neuroleptics prescribed for schizophrenic patients was studied. Methods: 90 outpatients with schizophrenic disorder (DSM-III-R) who were on a stable regimen of psychotropic medication and showed a stable clinical state were included in a double-blind placebo-controlled trial. Data were collected and blood tests taken at the baseline interview. The plasma levels were obtained for 52 patients. Results: Daily neuroleptic doses converted to chlorpromazine equivalents correlated significantly (r = 0.436) with the plasma levels of their unmetabolised fractions. The neuroleptic doses increased with age in smokers, while in nonsmokers they decreased. Neither sex, age nor smoking had a significant association with the neuroleptic plasma levels. Conclusions: Smoking seems to lead to increased neuroleptic dosages in postmenopausal schizophrenics by increasing hepatic metabolism and renal excretion of the drugs and possibly enhancing dopamine release. It is also possible that older smoking patients form a selected group of heavy smokers and they, therefore, need exceptionally high neuroleptic doses.

Pharmacopsychiatry, 2007

Recent disclosures regarding the relationship between Heidegger's thought and his own version of National Socialism have led me to rethink my earlier efforts to portray Heidegger as a forerunner of deep ecology. His political problems have provided ammunition for critics, such as Murray Bookchin, who regard deep ecology as a reactionary movement. In this essay, I argue that, despite some similarities, Heidegger's thought and deep ecology are in many ways incompatible, in part because deep ecologists—in spite of their criticism of the ecologically destructive character of technological modernity—generally support a " progressive " idea of human evolution. Environmental Ethics, Vol. 15, No. 3 (Fall, 1993), 195-224.