Varenicline treatment for smokers with schizophrenia: a case series.

摘要: Sir: Schizophrenia is associated with increased prevalence of smoking, heavy and smoking-related morbidity mortality. Standard nicotine dependence treatments have been modest efficacy in patients schizophrenia high rates relapse to smoking upon their discontinu- ation. 1-3 These reports prompted the authors review clinical nico- tine treatment varenicline smokers at an urban community mental health clinic attention for signs worsening that may occurred secondary treatment. Method. From October 2006 2007, 19 schizophrenia, most whom had quit past but relapsed after discontinuation bupropion or replacement therapy, requested newly available medication, varenicline. outpatients were on stable antipsychotic medication regimens received a standard titration as fol- lows: 0.5 mg/day 3 days, mg b.i.d. 4 then 1 Each brief individual counseling visits. Visits weekly 2 weeks, approximately monthly. Results. All reported reduced craving smoke initiating Four discontinued due nausea vomiting. One patient subsequently restarted was able tolerate treat- ment without vomiting second exposure. Thirteen pa- tients tolerated within 10 21 days starting varenicline, maintained self-reported absti- nence ≥ 12 verified periodic expired air carbon monoxide measurements < 9 ppm In pe- riod between 24 occasional "slips" which they smoked 5 cigarettes per day period 7 regained abstinence. 13 this series who elected continue take beyond 24-week regi- men prevent smoking. Patients remained clinically no evidence psy- chotic significant psychiatric symptoms side effects medications. None hospitalization weeks start- ing No rating scales performed part Likewise, cognitive tests assess effect performance these patients. Varenicline partial α 4β2 full nicotinic acetylcho- line receptor (nAChR) agonist.