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Smoking in schizophrenia

recent findings about an old problem

Sagud, Marinaa,b; Mihaljevic Peles, Almaa,b; Pivac, Nelac

doi: 10.1097/YCO.0000000000000529
PSYCHIATRY, MEDICINE AND THE BEHAVIOURAL SCIENCES: Edited by Mohan Isaac and Igor Filipcic
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Purpose of review Recent epidemiology, biological and clinical findings correlate high cigarette consumption in patients with schizophrenia, impeding both treatment strategies and the effectiveness of antipsychotics.

Recent findings New data suggests that despite world-wide efforts to curb cigarette consumption, smoking in patients with schizophrenia was still high. Recent reports could not confirm earlier findings regarding smoking's beneficial effects on cognitive dysfunction, however, the association between smoking, positive symptoms and suicidal behavior was revealed. As some patients smoked in an attempt to alleviate extrapyramidal symptoms (EPS) and negative symptoms, the molecular studies shared genetic roots correlating smoking and schizophrenia, revealing that smoking may increase the risk of developing schizophrenia. Preclinical and clinical studies clarified the complex relationship between schizophrenia's pathology and nicotine's effects on the human brain.

Summary Cigarette smoking continues to adversely affect the health of individuals with schizophrenia. Both smoking and heavy nicotine dependence, given the complex biological findings, might influence symptom severity in patients with schizophrenia. Regardless, ceasing smoking activities is strongly advocated to replace ‘self-medication by nicotine’ with safer and more effective medications.

aSchool of Medicine, University of Zagreb

bDepartment of Psychiatry, University Hospital Centre Zagreb, Kispaticeva

cDivision of Molecular Medicine, Rudjer Boskovic Institute, Zagreb, Croatia

Correspondence to Marina Sagud, Assistant Professor, Department of Psychiatry, University Hospital Centre Zagreb, Kišpatićeva 12, 10 000 Zagreb, Croatia. Tel: +38512388386; e-mail: marinasagud@mail.com

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