Maintenance pharmacotherapy normalizes the relapse curve in recently abstinent tobacco smokers with schizophrenia and bipolar disorder
| Autor: | Corinne Cather, David A. Schoenfeld, Bettina B. Hoeppner, Susanne S. Hoeppner, Melissa Culhane Maravic, Gladys N. Pachas, Kristina M. Cieslak, A. Eden Evins |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Bipolar Disorder Time Factors media_common.quotation_subject Population Placebo Article law.invention 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Pharmacotherapy Randomized controlled trial law Internal medicine medicine Humans 030212 general & internal medicine Bipolar disorder Nicotinic Agonists Psychiatry education Varenicline Biological Psychiatry media_common Probability education.field_of_study Smokers Cognitive Behavioral Therapy Tobacco Use Disorder Abstinence Middle Aged medicine.disease Psychiatry and Mental health Treatment Outcome chemistry Schizophrenia Female Psychology 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Schizophrenia Research. |
| ISSN: | 0920-9964 |
| DOI: | 10.1016/j.schres.2016.11.018 |
| Popis: | To compare the effect of maintenance pharmacotherapy on sustained abstinence rates between recently abstinent smokers with schizophrenia and bipolar disorder (SBD) and general population smokers without psychiatric illness.We performed a person-level, pooled analysis of two randomized controlled trials of maintenance varenicline, conducted in adult smokers with SBD and general population smokers, controlling for severity of dependence. Smokers abstinent after 12-weeks of open varenicline treatment were randomly assigned to ≥12-weeks maintenance varenicline or identical placebo.In those assigned to maintenance placebo, the abstinence rate at week-24 was lower in those with SBD than for those without psychiatric illness (29.4±1.1% vs. 61.8±0.4%, OR:0.26, 95% CI: 0.13, 0.52, p0.001). In smokers assigned to maintenance pharmacotherapy, however, there was no effect of diagnosis on abstinence rates at week-24 (87.2±0.8% vs. 81.9±0.2%, OR: 1.68, 95% CI: 0.53, 5.32, p=0.38). Time to first lapse was shortest in those with SBD assigned to maintenance placebo (Q1=12days, 95%CI: 4, 16), longer in those without psychiatric illness assigned to maintenance placebo (Q1=17days, 95%CI: 17, 29), still longer in general-population smokers assigned to maintenance varenicline (Q1=88, 95% CI:58,91, and longest in those with SBD who received maintenance varenicline (Q195days, 95%CI:non-est), (ΧFollowing a standard 12-week course of pharmacotherapy, people with schizophrenia and bipolar disorder were more likely to relapse to smoking without maintenance varenicline treatment. Maintenance pharmacotherapy could improve longer-term tobacco abstinence rates and reduce known smoking-related health disparities in those with SMI. |
| Databáze: | OpenAIRE |
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