title: Effects of acute abstinence, reinstatement, and mecamylamine on biochemical and behavioral measures of cigarette smoking in schizophrenia.
abstract: BACKGROUND
  Schizophrenics have higher rates of smoking than the general population, and more difficulty with smoking cessation. However, there has been little study of differences between schizophrenics and controls with respect to biochemical and behavioral indices of smoking. We compared smokers with schizophrenia (SS; n=27) and control smokers (CS; n=26) on smoking and psychiatric outcomes at baseline, during acute smoking abstinence and reinstatement, and with pre-treatment using the nicotinic acetylcholine receptor (nAChR) antagonist mecamylamine (MEC) in a human laboratory setting.
  
  
  METHODS
  Biochemical (e.g., plasma nicotine) and behavioral (e.g., craving, withdrawal) outcomes were assessed at baseline, after overnight abstinence, and after smoking reinstatement during three consecutive test weeks. Each week, participants received one of three doses of MEC (0.0, 5.0, or 10.0 mg/dayx3 days) in a randomized, counterbalanced manner.
  
  
  RESULTS
  Compared to CS, SS displayed similar levels of craving and withdrawal, but higher plasma nicotine and cotinine levels, and cotinine/CPD ratio. During reinstatement, SS consumed significantly more cigarettes than CS, but MEC did not significantly alter indices of smoking, psychiatric symptoms, or cigarette consumption during reinstatement.
  
  
  CONCLUSIONS
  1) The reinforcing effects of smoking may be increased in SS versus CS after overnight abstinence; 2) the lack of effects of nAChR antagonism may suggest that non-nicotinic components of cigarettes may contribute to the behavioral effects of smoking in both SS and CS; and 3) consistent with previous studies, SS may exhibit higher baseline levels of nicotine and cotinine, and greater extraction of nicotine per cigarette than CS.
authors.affiliation: Program for Research on Smokers with Mental Illness (PRISM), Yale University School of Medicine, Department of Psychiatry, 34 Park Street, New Haven, CT 06519, USA. andrea.weinberger@yale.edu
authors.forename: Andrea H
authors.initials: AH
authors.lastname: Weinberger
authors.forename: Kristi A
authors.initials: KA
authors.lastname: Sacco
authors.forename: Cerissa L
authors.initials: CL
authors.lastname: Creeden
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Vessicchio
authors.forename: Peter I
authors.initials: PI
authors.lastname: Jatlow
authors.forename: Tony P
authors.initials: TP
authors.lastname: George
mesh_terms: D000208:Acute Disease; D000328:Adult; D003367:Cotinine / Q000097:blood; D003710:Demography; D003863:Depression / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008464:Mecamylamine / Q000494:pharmacology / Q000627:therapeutic use*; D009538:Nicotine / Q000009:adverse effects* / Q000097:blood; D018733:Nicotinic Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D015995:Prevalence; D011618:Psychotic Disorders / Q000175:diagnosis / Q000209:etiology*; D011978:Receptors, Nicotinic / Q000187:drug effects; D012008:Recurrence; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology*; D012720:Severity of Illness Index; D016540:Smoking Cessation / Q000379:methods; D000074606:Smoking Prevention; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy* / Q000209:etiology*; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*
chemical_list: D018733:Nicotinic Antagonists; D011978:Receptors, Nicotinic; D008464:Mecamylamine; D009538:Nicotine; D003367:Cotinine