Nicotine transdermal patch and atypical antipsychotic medications for smoking cessation in schizophrenia

Schizophrenic patients have high rates of cigarette smoking. The authors compared the outcomes of 2 group psychotherapy programs for smoking cessation in Ss (mean ages 36.6–42 yrs) with schizophrenia or schizoaffective disorder who were treated with the nicotine transdermal patch (NTP) and with either atypical (ATYP) or typical (TYP) antipsychotics. Forty-five Ss were randomly assigned to (1) the group therapy (GT) program of the American Lung Association, or (2) a specialized GT program for smokers with schizophrenia that emphasized motivation enhancement, relapse prevention, social skills training, and psychoeducation. Outcome variables included treatment retention, rate of smoking abstinence, and expired-breath carbon monoxide level. ATYP agents, in combination with the NTP, significantly enhanced the rate of smoking cessation (55.6% in the ATYP group vs 22.2% in the TYP group), reflected by a significant effect of ATYP vs TYP agents on carbon monoxide levels. Smoking cessation rates with the NTP are modest in schizophrenia. Specialized GT is not significantly different from American Lung Association GT in its effect on smoking cessation, and ATYP agents may be superior to TYP agents in combination with the NTP for smoking cessation in patients with schizophrenia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)