Schizophrenia and smoking.
Smoking is associated with the induction of the CYP 1A2 enzyme, and hence with diminished levels of drugs metabolized by this enzyme. This article presents a hypothetical patient, diagnosed with schizophrenia, who smokes about 10 cigarettes a day. The progress of the patient is examined across several follow up meetings, each of which presents a fresh clinical problem related to smoking and its interaction with the medication. Clinical guidance for each problem is presented along with a brief discussion on the subject. The article concludes with a discussion of other pharmacokinetic considerations related to smoking and its treatment in patients with schizophrenia.
Department of Psychopharmacology, National Institute of Mental Health and Neurosciences, Bangalore, India. candrade@psychiatrist.com
Chittaranjan
C
Andrade
D000328:Adult; D003024:Clozapine / Q000493:pharmacokinetics* / Q000627:therapeutic use; D019388:Cytochrome P-450 CYP1A2 / Q000187:drug effects* / Q000378:metabolism; D004790:Enzyme Induction / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D008658:Inactivation, Metabolic / Q000502:physiology; D008297:Male; D012559:Schizophrenia / Q000188:drug therapy* / Q000378:metabolism; D012565:Schizophrenic Psychology; D012907:Smoking / Q000009:adverse effects* / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods
D019388:Cytochrome P-450 CYP1A2; D003024:Clozapine