Randomized Trial of the Effect of Four Second-Generation Antipsychotics and One First-Generation Antipsychotic on Cigarette Smoking, Alcohol, and Drug Use in Chronic Schizophrenia

Somaia Mohamed; Robert A Rosenheck; Haiqun Lin; Marvin Swartz; Joseph McEvoy; Scott Stroup

doi:10.1097/NMD.0000000000000317

Randomized Trial of the Effect of Four Second-Generation Antipsychotics and One First-Generation Antipsychotic on Cigarette Smoking, Alcohol, and Drug Use in Chronic Schizophrenia

J Nerv Ment Dis. 2015 Jul;203(7):486-92. doi: 10.1097/NMD.0000000000000317.

Authors

Somaia Mohamed¹, Robert A Rosenheck, Haiqun Lin, Marvin Swartz, Joseph McEvoy, Scott Stroup

Affiliation

¹ *New England Mental Illness, Research, Education and Clinical Center, West Haven; †Yale Medical School, New Haven, CT; ‡Duke University, Durham, NC; §Georgia Regents University, Augusta; and ∥Columbia College of Physicians and Surgeons, New York, NY.

PMID: 26075840
DOI: 10.1097/NMD.0000000000000317

Abstract

No large-scale randomized trial has compared the effect of different second-generation antipsychotic drugs and any first-generation drug on alcohol, drug and nicotine use in patients with schizophrenia. The Clinical Antipsychotic Trial of Intervention Effectiveness study randomly assigned 1432 patients formally diagnosed with schizophrenia to four second-generation antipsychotic drugs (olanzapine, risperidone quetiapine, and ziprasidone) and one first-generation antipsychotic (perphenazine) and followed them for up to 18 months. Secondary outcome data documented cigarettes smoked in the past week and alcohol and drug use severity ratings. At baseline, 61% of patients smoked, 35% used alcohol, and 23% used illicit drugs. Although there were significant effects of time showing reduction in substance use over the 18 months (all p < 0.0001), this study found no evidence that any antipsychotic was robustly superior to any other in a secondary analysis of data on substance use outcomes from a large 18-month randomized schizophrenia trial.

Publication types

Comparative Study
Randomized Controlled Trial

MeSH terms

Adolescent
Adult
Aged
Alcoholism / epidemiology*
Alcoholism / rehabilitation*
Antipsychotic Agents / adverse effects
Antipsychotic Agents / therapeutic use*
Benzodiazepines / adverse effects
Benzodiazepines / therapeutic use
Chronic Disease
Comorbidity
Cross-Sectional Studies
Dibenzothiazepines / adverse effects
Dibenzothiazepines / therapeutic use
Double-Blind Method
Female
Humans
Illicit Drugs*
Male
Middle Aged
Olanzapine
Perphenazine / adverse effects
Perphenazine / therapeutic use
Piperazines / adverse effects
Piperazines / therapeutic use
Psychiatric Status Rating Scales
Quetiapine Fumarate
Risperidone / adverse effects
Risperidone / therapeutic use
Schizophrenia / epidemiology*
Schizophrenia / rehabilitation*
Schizophrenic Psychology
Smoking / epidemiology*
Smoking Prevention*
Substance-Related Disorders / epidemiology*
Substance-Related Disorders / rehabilitation*
Thiazoles / adverse effects
Thiazoles / therapeutic use
Young Adult

Substances

Antipsychotic Agents
Dibenzothiazepines
Illicit Drugs
Piperazines
Thiazoles
Benzodiazepines
Quetiapine Fumarate
ziprasidone
Perphenazine
Risperidone
Olanzapine