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Uso del tabaco en la esquizofrenia: un estudio de las concentraciones de cotinina en la saliva de pacientes y controles

Published online by Cambridge University Press:  12 May 2020

Jan-Erik Strand  and
Henrik Nybäck
Jan-Erik Strand
Affiliation:
Departamento de Psiquiatría, Hospital Central Vasa, Vasa, Finlandia
Henrik Nybäck
Affiliation:
Departamento de Neurociencia Clínica, Sección de Psiquiatría, Instituto Karolinska, Solna, Suecia
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Resumen

Se ha propuesto que la nicotina proporciona alivio de la ansiedad, gratificatión oral y automedicación de los síntomas psicóticos en los pacientes psiquiátricos. Para investigar las relaciones entre las alteraciones psicopatológicas y el uso del tabaco, medimos la concentratión de cotinina, el metabolito principal de la nicotina, en la saliva de pacientes psiquiátricos y voluntaries sanos. En una muestra de 42 pacientes esquizofrénicos correlacionamos la categoría de fumador, las concentraciones de cotinina, los perfiles de síntomas (PANSS) y los efectos secundarios de los neurolépticos (Simpson-Angus). A pesar de informar de la misma cantidad de cigarrillos consumidos por día, la concentración de cotinina en la saliva era significativamente más alta en los pacientes con esquizofrenia que en los controles. No hubo diferencias significativas en las características clínicas entre los pacientes esquizofrénicos fumadores y no fumadores, pero los fumadores tendían a estar con dosis más altas de fármacos. Las concentraciones altas de cotinina correlacionaban significativamente con los síntomas negativos Retraimiento pasivo y Aislamiento social. Los resultados indican que los pacientes esquizofrénicos fuman cigarrillos con más intensidad que otros pacientes y los sujetos sanos. La correlatión entre los niveles altos de cotinina y los síntomas negativos puede reflejar un intento por los pacientes esquizofrénicos de superar la retirada emocional y, así, los resultados pueden prestar apoyo a una hipótesis de automedicación.

Keywords

FumarNicotinaCotininaEsquizofreniaPANSS
Type
Artículo original
Information
European Psychiatry (Ed. Española) , Volume 12 , Issue 6 , September 2005 , pp. 318 - 322
Copyright
Copyright © European Psychiatric Association 2005

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References

Bibliografía

[1] Adler, LE, Hoffer, LD, Wiser, A, Freedman, R. Normalization of auditory physiology by cigarette smoking in schizophrenic patients. Am J Psych 1993;150:1856–61.Google ScholarPubMed
[2] American Psychiatric Association. DSM-1II-R: diagnostic and statistical manual of mental disorders. 3rd ed. revised. Washington (DC): APA; 1987.Google Scholar
[3] Andersson, G, Kazemi Vala, E, Curvall, M. The influence of cigarette consumption and smoking machine yields of tar and nicotine on the nicotine uptake and oral mucosal lesions in smokers. J Oral Pathol Med 1997;26:117–23.CrossRefGoogle ScholarPubMed
[4] Arneric, SP. The therapeutic potential of modulators of functional and dysfunctional neuronal nicotinic acetylcholine receptors. In: Proceedings of the IBC's International Conference on Nicotinic Acetylcholine Receptors as Pharmaceutical Targets. 1997 July 24- 25; Washington, DC, USA.Google Scholar
[5] Bejerot, S, Humble, M. Low prevalence of smoking among patients with obsessive-compulsive disorder. Compr Psychiatry 1999;40: 268-72.CrossRefGoogle ScholarPubMed
[6] Benowitz, NL, Jacob, P. Daily intake of nicotine during cigarette smoking. Clin Pharmacol Ther 1984;35:499–504.CrossRefGoogle ScholarPubMed
[7] Clarke, PBS, Hommer, DW, Pert, A, Skirboll, LR. Electrophysiological actions of nicotine on substantia nigra single units. Br J Pharmacol 1985;85:827–35.Google ScholarPubMed
[8] Clarke, PBS, Pert, A. Autoradiographic evidence for nicotine receptors on nigrostriatal and mesolimbic dopaminergic neurons. Brain Res 1985;348:355–8.CrossRefGoogle ScholarPubMed
[9] Corvin, A, O'Mahony, E, O'Regan, M, Comerford, C, O'Connell, R, Craddock, N, Gill, M. Cigarette smoking and psychotic symptoms in bipolar affective disorder. Br J Psychiatry 2001;179:35–8.CrossRefGoogle ScholarPubMed
[10] Coultas, DB, Stidley, CA, Samet, JM. Cigarette yields of tar and nicotina and markers of exposure to tobacco smoke. Am Rev Respir Dis 1993;148:435–40.CrossRefGoogle ScholarPubMed
[11] Curvall, M, Kazemi Vala, E, Enzell, C. Simultaneous determination of nicotine and cotinine in plasma using capillary gas chromatography with nitrogen-sensitive detection. J Chromatogr 1982;232:283–93.Google ScholarPubMed
[12] Dawe, S, Gerada, C, Russell, MA, Gray, JA. Nicotine intake in smokers increases following a single dose of haloperidol. Psychopharmacol( Berl) 1995;117:110–5.Google ScholarPubMed
[13] Feyerabend, C, Russell, MAH. A rapid gas chromatography method for the determination of cotinine and nicotine in biological fluids. J Pharm Pharmacol 1990;42:450–2.CrossRefGoogle ScholarPubMed
[14] Glassman, AH. Cigarette smoking: implications for psychiatric illness. Am J Psychiatry 1993;50:546–53.Google Scholar
[15] Goff, DC, Henderson, DC, Amico, E. Cigarette smoking in schizophrenia: relationship to psychopathology and medication side effects. Am J Psychiatry 1992;149:1189–94.Google ScholarPubMed
[16] Grenhoff, J, Aston-Jones, G, Svensson, T. Nicotinic effects on the firing pattern of midbarin dopamine neurons. Acta Physiol Scand 1986;128:351–8.CrossRefGoogle ScholarPubMed
[17] Herning, RI, Jones, RT, Benowitz, NL, Mines, AH. How a cigarette is smoked determines blood nicotine levels. Clin Pharmacol Ther 1983;33:84–90.CrossRefGoogle ScholarPubMed
[18] Hughes, JR, Hatsukami, DK, Mitchell, JE, Dahlgren, LA. Prevalence of smoking among psychiatric outpatients. Am J Psychiatry 1986; 143:993–7.Google ScholarPubMed
[19] Jarvis, MJ, Russell, MA, Benowitz, NL, Feyerabend, C. Elimination of cotinine from body fluids: implications for non-invasive measurement of tobacco smoke exposure. Am J Publ Health 1988;78:696–8.CrossRefGoogle Scholar
[20] von Knorring, L, Lindstrom, E. The Swedish version of the positive and negative syndrome scale (PANSS) for schizophrenia. Acta Psychiatr Scand 1992;86:463–8.CrossRefGoogle Scholar
[21] Lohr, JB, Flynn, K. Smoking and schizophrenia. Schizophr Res 1992;8:93–102.CrossRefGoogle Scholar
[22] Nisell, M, Nomikos, GG, Svensson, TH. Nicotine dependence, midbrain dopamine systems and psychiatric disorders. Pharmacol Toxicol 1995;76:157–62.Google ScholarPubMed
[23] Nyback, H, Halldin, C, Ahlin, A, Curvall, M, Eriksson, L. PET studies of the uptake of (S)- and (R)-[l1C] nicotine in the human brain: difficulties in visualizing specific receptor binding in vivo. Psychopharmacology (Bed) 1994; 115:31–6.CrossRefGoogle ScholarPubMed
[24] Overall, JE, Gorham, DR. Brief psychiatric rating scale. Psychol Rep 1962;10:799–812.CrossRefGoogle Scholar
[25] Pérez-Stable, EJ, Benowitz, NL, Marin, G. Is serum cotinine a better measure of cigarette smoking than self-report? Prev Med 1995;24:171-9.CrossRefGoogle ScholarPubMed
[26] Salokangas, RK, Saarijarvi, S, Taiminen, T, et al. Effect of smoking on neuroleptics in schizophrenia. Schizophr Res 1997;23:55–60.CrossRefGoogle Scholar
[27] Sandyk, R. Cigarette smoking: effects on cognitive functions and drug-induced Parkinsonism in chronic schizophrenia. Int J Neurosci 1993;70:193–7.CrossRefGoogle ScholarPubMed
[28] Simpson, EN, Angus, JWEA rating scale for extrapyramidal sideeffects. Acta Psychiatr Scand 1970(Suppl):212.Google Scholar
[29] Wagenknecht, LE, Burke, GL, Perkins, LL, Haley, NJ, Friedman, GD. Misclassification of smoking status in the CARDIA study: a comparison of self-report with serum cotinine levels. Am J Public Health 1992;82:33–6.CrossRefGoogle ScholarPubMed
[30] Wagner, B, Wolf, GK, Ulmar, K. Does smoking reduce the risk of neuroleptic parkinsonoids? Pharmacopsychiatry 1988;21:302–3.CrossRefGoogle ScholarPubMed
[31] Wonnacott, S, Russell, MAH, Stolerman, IRNicotine psychopharmacology. Oxford University Press; 1990.Google Scholar