Smoking in patients receiving psychotropic medications: a pharmacokinetic perspective.
paper
Cited
Public
Unavailable
- Authors
- Desai, H D; Seabolt, J; Jann, M W
- Year
- 2001
- Journal
- CNS drugs
- PMID
- 11524025
- DOI
- 10.2165/00023210-200115060-00005
Many psychiatric patients smoke, and are believed to be heavier smokers than those without psychiatric disorders. Cigarette smoking is one of the environmental factors that contributes to interindividual variations in response to an administered drug. Polycyclic aromatic hydrocarbons (PAHs) present in cigarette smoke induce hepatic aryl hydrocarbon hydroxylases, thereby increasing metabolic clearance of drugs that are substrates for these enzymes. PAHs have been shown to induce 3 hepatic cytochrome P450 (CYP) isozymes, primarily CYP1A1, 1A2 and 2E1. Drug therapy can also be affected pharmacodynamically by nicotine. The most common effect of smoking on drug disposition in humans is an increase in biotransformation rate, consistent with induction of drug-metabolising enzymes. Induction of hepatic enzymes has been shown to increase the metabolism and to decrease the plasma concentrations of imipramine, clomipramine, fluvoxamine and trazodone. The effect of smoking on the plasma concentrations of amitriptyline and nortriptyline is variable. Amfebutamone (bupropion) does not appear to be affected by cigarette smoking. Smoking is associated with increased clearance of tiotixene, fluphenazine, haloperidol and olanzapine. Plasma concentrations of chlorpromazine and clozapine are reduced by cigarette smoking. Clinically, reduced drowsiness in smokers receiving chlorpromazine, and benzodiazepines, compared with nonsmokers has been reported. Increased clearance of the benzodiazepines alprazolam, lorazepam, oxazepam, diazepam and demethyl-diazepam is found in cigarette smokers, whereas chlordiazepoxide does not appear to be affected by smoking. Carbamazepine appears to be minimally affected by cigarette smoke, perhaps because hepatic enzymes are already stimulated by its own autoinductive properties. Cigarette smoking can affect the pharmacokinetic and pharmacodynamic properties of many psychotropic drugs. Clinicians should consider smoking as an important factor in the disposition of these drugs.
No figures extracted from this document.
No chunks — full text not yet ingested.
No entities extracted from this document yet.
No uploaded files.
Not in any collection.
No citations found.
In this knowledge base
External
| Title | Authors | Journal | Year | Link |
|---|---|---|---|---|
| [Nicotine consumption in childhood and adolescence-fundamentals and considerations for handling the topic in child and adolescent psychiatric settings]. | Schögl P et al. | — | 2026 | → |
| Association between smoking and duration of regional anesthesia - A propensity score matching study. | Machiyama Y et al. | — | 2025 | → |
| Evaluation of drug interactions in outpatients taking antipsychotic medications. | Alsfouk BA et al. | — | 2025 | → |
| "Everybody's problem but nobody's problem": Qualitative study on integrating smoking cessation and mental health services in Singapore. | Lok YL et al. | — | 2025 | → |
| Joint Clinical Practice Guideline on Benzodiazepine Tapering: Considerations When Risks Outweigh Benefits. | Brunner E et al. | — | 2025 | → |
| Model-Informed Precision Dosing of Levamlodipine Besylate in Smoking Patients. | Li G et al. | — | 2025 | → |
| Smoking may increase the usage of antidepressant: evidence from genomic perspective analysis. | Qu Y et al. | — | 2025 | → |
| Video consultation and treatment in the community smoking cessation therapy success rates in patients with mental illness: a randomized controlled trial. | Kaasgaard DM et al. | — | 2024 | → |
| Association of smoking cigarettes, age, and sex with serum concentrations of olanzapine in patients with schizophrenia. | Horvat M et al. | — | 2023 | → |
| Prevalence of tobacco smoking in people at clinical high-risk for psychosis: Systematic review and meta-analysis. | De Micheli A et al. | — | 2023 | → |
| Psychopharmacology of smoking cessation medications: focus on patients with mental health disorders. | Castaldelli-Maia JM et al. | — | 2023 | → |
| Pairwise genetic meta-analyses between schizophrenia and substance dependence phenotypes reveals novel association signals with pharmacological significance. | Greco LA et al. | — | 2022 | → |
| Prescribing clozapine in the UK: Quality improvement issues identified by clinical audit. | Barnes TR et al. | — | 2022 | → |
| The effect of smoking on the plasma concentration of tricyclic antidepressants: a systematic review. | Lundstrøm NH et al. | — | 2022 | → |
| TOBACCO USE DISORDER AND DUAL DISORDERS Joint statement by the Spanish Psychiatry Society and the Spanish Dual Disorders Society. | Néstor S et al. | — | 2022 | → |
| Assessment of potential drug interactions among psychiatric inpatients receiving antipsychotic therapy of a secondary care hospital, United Arab Emirates. | Aburamadan HAR et al. | — | 2021 | → |
| Comparison of Efficacy and Safety between Long-Acting Injectable Antipsychotic Monotherapy and Combination of Long-Acting Injectable and Oral Antipsychotics in Patients with Schizophrenia. | Sathienluckana T et al. | — | 2021 | → |
| Fluctuation between cigarette smoking and use of electronic nicotine delivery systems: Impact on clozapine concentrations and clinical effect. | Montville DJ et al. | — | 2021 | → |
| Predictors of Nutritional Status, Depression, Internet Addiction, Facebook Addiction, and Tobacco Smoking Among Women With Eating Disorders in Spain. | Ali AM et al. | — | 2021 | → |
| Safety Net Provider Attitudes Toward Smoking Cessation Treatment. | Meredith LR et al. | — | 2021 | → |
| Evidence for causal effects of lifetime smoking on risk for depression and schizophrenia: a Mendelian randomisation study. | Wootton RE et al. | — | 2020 | → |
| How Can Drug Metabolism and Transporter Genetics Inform Psychotropic Prescribing? | Carvalho Henriques B et al. | — | 2020 | → |
| Identification of 34 genes conferring genetic and pharmacological risk for the comorbidity of schizophrenia and smoking behaviors. | Ma Y et al. | — | 2020 | → |
| Improving Smoking Cessation Outcomes Through Tailored-Risk Patient Messages at a University Hospital Tobacco Cessation Service. | Gonzales D et al. | — | 2020 | → |
| Pharmacotherapy for smoking cessation in schizophrenia: a systematic review. | Kozak K et al. | — | 2020 | → |
| Treatment Outcomes of a Multi-Component Mobile Health Smoking Cessation Pilot Intervention for People with Schizophrenia. | Medenblik AM et al. | — | 2020 | → |
| A Cluster-Randomized Clinical Trial Testing the Effectiveness of the Addressing Tobacco Through Organizational Change Model for Improving the Treatment of Tobacco Use in Community Mental Health Care: Preliminary Study Feasibility and Baseline Findings. | Flitter AS et al. | — | 2019 | → |
| Analysis of smoking behavior on the pharmacokinetics of antidepressants and antipsychotics: evidence for the role of alternative pathways apart from CYP1A2. | Scherf-Clavel M et al. | — | 2019 | → |
| Evaluation of an Online Residency Training in Tobacco Use Disorder. | Williams JM et al. | — | 2019 | → |
| Factors associated with alcohol consumption and prescribed drugs with addiction potential among older women and men - the Nord-Trøndelag health study (HUNT2 and HUNT3), Norway, a population-based longitudinal study. | Tevik K et al. | — | 2019 | → |
| Nicotine consumption during the prodromal phase of schizophrenia - a review of the literature. | Gogos A et al. | — | 2019 | → |
| Patient-Informed Treatment Development of Behavioral Smoking Cessation for People With Schizophrenia. | Wilson SM et al. | — | 2019 | → |
| Psychopathology and extrapyramidal side effects in smoking and non-smoking patients with schizophrenia: Systematic review and meta-analysis of comparative studies. | Huang H et al. | — | 2019 | → |
| Schizophrenia and Nicotine Dependence: What Psychopharmacological Treatment Options are Available for the Duo Perturbationes? | Theng YM et al. | — | 2019 | → |
| Causal effects of lifetime smoking on risk for depression and schizophrenia: Evidence from a Mendelian randomisation study | Wootton RE et al. | — | 2018 | — |
| Complex Polypharmacy in Patients With Schizophrenia-Spectrum Disorders Before a Psychiatric Hospitalization: Prescribing Patterns and Associated Clinical Features. | Gaudiano BA et al. | — | 2018 | → |
| Diabetes outcomes in people with severe mental illness. | Cohen A et al. | — | 2018 | → |
| Effects of smoking and body mass index on the exposure of fentanyl in patients with cancer. | Kuip EJM et al. | — | 2018 | → |
| The Convention on the Rights of Persons with Disabilities as a tobacco control tool in the mental health setting. | van der Eijk Y | — | 2018 | → |
| Achieving Smoking Cessation in Individuals with Schizophrenia: Special Considerations. | Cather C et al. | — | 2017 | → |
| Cigarette smoking and schizophrenia: a specific clinical and therapeutic profile? Results from the FACE-Schizophrenia cohort. | Mallet J et al. | — | 2017 | → |
| Combination Extended Smoking Cessation Treatment Plus Home Visits for Smokers With Schizophrenia: A Randomized Controlled Trial. | Brody AL et al. | — | 2017 | → |
| Does the number of previous mood episodes moderate the relationship between alcohol use, smoking and mood in bipolar outpatients? | Ter Meulen WG et al. | — | 2017 | → |
| Investigating causality in associations between smoking initiation and schizophrenia using Mendelian randomization. | Gage SH et al. | — | 2017 | → |
| Predicting drug interactions in addiction treatment. | Lucas CJ et al. | — | 2017 | → |
| Psychoactive substance use in specialized psychiatric care patients. | Karpov B et al. | — | 2017 | → |
| Smoking, psychiatric illness and the brain. | Boksa P | — | 2017 | → |
| [When and how prescribe antipsychotics?] | Tebeka S et al. | — | 2017 | → |
| A Reasonable Alternative to Clozapine in the Chronically Relapsing Smoking Patient? A Retrospective Analysis. | Tomko JR et al. | — | 2016 | → |
| A Review of Impact of Tobacco Use on Patients with Co-occurring Psychiatric Disorders. | Pal A et al. | — | 2016 | → |
| Cigarettes & Psychotropic Medications: A study of the prescription pattern in an inpatient setting. | Husain-Krautter S et al. | — | 2016 | → |
| Nicotine dependence and psychosis in Bipolar disorder and Schizoaffective disorder, Bipolar type. | Estrada E et al. | — | 2016 | → |
| Pharmacogenetic tests for antipsychotic medications: clinical implications and considerations. | Eum S et al. | — | 2016 | → |
| Pharmacokinetics of paracetamol in patients with chronic pancreatitis. | Siepsiak M et al. | — | 2016 | → |
| Polysubstance-induced relapse of schizoaffective disorder refractory to high-dose antipsychotic medications: a case report. | Tucker MG et al. | — | 2016 | → |
| Effects of long-term smoking on the activity and mRNA expression of CYP isozymes in rats. | He XM et al. | — | 2015 | → |
| Prescription practices in the treatment of first-episode schizophrenia spectrum disorders: data from the national RAISE-ETP study. | Robinson DG et al. | — | 2015 | → |
| Rethinking the association between smoking and schizophrenia. | Gage SH et al. | — | 2015 | → |
| Smoking and mental illness. An update for psychiatrists. | Mendelsohn CP et al. | — | 2015 | → |
| Smoking Use and Cessation Among People with Serious Mental Illness. | Annamalai A et al. | — | 2015 | → |
| The effect of nicotine dependence on psychopathology in patients with schizophrenia. | Yee A et al. | — | 2015 | → |
| Comorbidity of severe psychotic disorders with measures of substance use. | Hartz SM et al. | — | 2014 | → |
| Effect of smoking on the pharmacokinetics of inhaled loxapine. | Takahashi LH et al. | — | 2014 | → |
| EPA guidance on tobacco dependence and strategies for smoking cessation in people with mental illness. | Rüther T et al. | — | 2014 | → |
| Cigarette smoking modulates medication-associated deficits in a monetary reward task in patients with schizophrenia. | Lernbass B et al. | — | 2013 | → |
| Clinically significant drug interactions with atypical antipsychotics. | Kennedy WK et al. | — | 2013 | → |
| Complete ultrarapid metabolism of flupentixol in 42 year old patient suffering from chronic schizophrenia. | Koch HJ et al. | — | 2013 | → |
| Interventions for smoking cessation and reduction in individuals with schizophrenia. | Tsoi DT et al. | — | 2013 | → |
| Smoking behaviour and mental health disorders--mutual influences and implications for therapy. | Minichino A et al. | — | 2013 | → |
| Parkinsonism in elderly users of haloperidol: associated with dose, plasma concentration, and duration of use. | Knol W et al. | — | 2012 | → |
| Smoking, quitting, and psychiatric disease: a review. | Aubin HJ et al. | — | 2012 | → |
| Treatment of tobacco dependence in people with mental health and addictive disorders. | Mackowick KM et al. | — | 2012 | → |
| A comprehensive model for mental health tobacco recovery in new jersey. | Williams JM et al. | — | 2011 | → |
| Pharmacogenetics of response to antipsychotics in patients with schizophrenia. | Arranz MJ et al. | — | 2011 | → |
| Smoking rates among schizophrenia patients in Japan. | Shinozaki Y et al. | — | 2011 | → |
| Smoking reduces language lateralization: a dichotic listening study with control participants and schizophrenia patients. | Hahn C et al. | — | 2011 | → |
| Smoking reduction for persons with mental illnesses: 6-month results from community-based interventions. | Morris CD et al. | — | 2011 | → |
| Tobacco smoking and mental illness: important considerations. | Feeney S et al. | — | 2011 | → |
| A prospective study of the impact of smoking on outcomes in bipolar and schizoaffective disorder. | Dodd S et al. | — | 2010 | → |
| A register study of the impact of stopping third trimester selective serotonin reuptake inhibitor exposure on neonatal health. | Warburton W et al. | — | 2010 | → |
| A tobacco reconceptualization in psychiatry: toward the development of tobacco-free psychiatric facilities. | Moss TG et al. | — | 2010 | → |
| Cigarette smoking in patients with schizophrenia in China: prospective, multicentre study. | Wang CY et al. | — | 2010 | → |
| Confronting a neglected epidemic: tobacco cessation for persons with mental illnesses and substance abuse problems. | Schroeder SA et al. | — | 2010 | → |
| Motivation to quit smoking among hospitalised individuals with and without mental health disorders. | Siru R et al. | — | 2010 | → |
| Smoking, nicotine and neuropsychiatric disorders. | Dome P et al. | — | 2010 | → |
| The promise and reality of pharmacogenetics in psychiatry. | Zandi PP et al. | — | 2010 | → |
| The promise and reality of pharmacogenetics in psychiatry. | Zandi PP et al. | — | 2010 | → |
| beta2-Nicotinic acetylcholine receptor availability during acute and prolonged abstinence from tobacco smoking. | Cosgrove KP et al. | — | 2009 | → |
| Determination of pharmacokinetic properties of clozapine and norclozapine in Korean schizophrenia patients. | Lee ST et al. | — | 2009 | → |
| Gender and interindividual variability in pharmacokinetics. | Nicolas JM et al. | — | 2009 | → |
| Management of smoking cessation in patients with psychiatric disorders. | Fagerström K et al. | — | 2009 | → |
| [Tobacco smoking and drug interactions]. | Molden E et al. | — | 2009 | → |
| Tobacco use among individuals with intellectual or developmental disabilities: a brief review. | Steinberg ML et al. | — | 2009 | → |
| Training psychiatrists and advanced practice nurses to treat tobacco dependence. | Williams JM et al. | — | 2009 | → |
| Treatment of tobacco dependence in mental health and addictive disorders. | Hitsman B et al. | — | 2009 | → |
| Going up in smoke: tobacco smoking is associated with worse treatment outcomes in mania. | Berk M et al. | — | 2008 | → |
| Long-term therapeutic drug monitoring of risperidone and olanzapine identifies altered steady-state pharmacokinetics: a clinical, two-group, naturalistic study. | Darby JK et al. | — | 2008 | → |
| Pharmacogenetics in psychiatry: are we ready for widespread clinical use? | Arranz MJ et al. | — | 2008 | → |
| Pharmacokinetics of olanzapine in Chinese male schizophrenic patients with various smoking behaviors. | Wu TH et al. | — | 2008 | → |
| Smoking cessation in patients with psychiatric disorders. | Gelenberg AJ et al. | — | 2008 | → |
| A 12-week double-blind, placebo-controlled study of bupropion sr added to high-dose dual nicotine replacement therapy for smoking cessation or reduction in schizophrenia. | Evins AE et al. | — | 2007 | → |
| Gender, age, smoking behaviour and plasma clozapine concentrations in 193 Chinese inpatients with schizophrenia. | Tang YL et al. | — | 2007 | → |
| Lactational state modifies alcohol pharmacokinetics in women. | Pepino MY et al. | — | 2007 | → |
| [Tobacco and schizophrenia: therapeutic aspects]. | Dervaux A et al. | — | 2007 | → |
| Tobacco smoking within psychiatric inpatient settings: biopsychosocial perspective. | Olivier D et al. | — | 2007 | → |
| Drug-induced changes in P450 enzyme expression at the gene expression level: a new dimension to the analysis of drug-drug interactions. | Lee MD et al. | — | 2006 | → |
| Effects of smoking on the pharmacokinetics of erlotinib. | Hamilton M et al. | — | 2006 | → |
| Interactions between antiepileptic and antipsychotic drugs. | Besag FM et al. | — | 2006 | → |
| Role of CYP pharmacogenetics and drug-drug interactions in the efficacy and safety of atypical and other antipsychotic agents. | Murray M | — | 2006 | → |
| A double-blind placebo-controlled trial of bupropion sustained-release for smoking cessation in schizophrenia. | Evins AE et al. | — | 2005 | → |
| An overview of psychotropic drug-drug interactions. | Sandson NB et al. | — | 2005 | → |
| Improving the care of individuals with schizophrenia and substance use disorders: consensus recommendations. | Ziedonis DM et al. | — | 2005 | → |
| Safety issues associated with herbal ingredients. | Elvin-Lewis M | — | 2005 | → |
| Tobacco smoke-dependent changes in cytochrome P450 1A1, 1A2, and 2E1 protein expressions in fetuses, newborns, pregnant rats, and human placenta. | Czekaj P et al. | — | 2005 | → |
| [Why do schizophrenic patients smoke?]. | Cattapan-Ludewig K et al. | — | 2005 | → |
| Addressing tobacco among individuals with a mental illness or an addiction. | Williams JM et al. | — | 2004 | → |
| Metabolism and biochemical effects of nicotine for primary care providers. | Metz CN et al. | — | 2004 | → |
| Retrospective evaluation of the effect of omeprazole on clozapine metabolism. | Mookhoek EJ et al. | — | 2004 | → |
| The differential effects of steady-state fluvoxamine on the pharmacokinetics of olanzapine and clozapine in healthy volunteers. | Wang CY et al. | — | 2004 | → |
| Characteristics of inmates receiving prescribed benzodiazepines in a high-security Greek prison. | Lekka NP et al. | — | 2003 | → |
| Clinical experience with the management of schizophrenia in the general hospital. | Freudenreich O et al. | — | 2003 | → |
| Conventional and atypical antipsychotics in the elderly : a review. | Gareri P et al. | — | 2003 | → |
| Interactions between the cytochrome P450 system and the second-generation antipsychotics. | Prior TI et al. | — | 2003 | → |
| Role of the smoking-induced cytochrome P450 (CYP)1A2 and polymorphic CYP2D6 in steady-state concentration of olanzapine. | Carrillo JA et al. | — | 2003 | → |
| Serious mental illness and tobacco addiction: a model program to address this common but neglected issue. | Ziedonis D et al. | — | 2003 | → |
| Therapeutic drug monitoring of olanzapine: the combined effect of age, gender, smoking, and comedication. | Gex-Fabry M et al. | — | 2003 | → |
| In vitro tests for predicting drug-drug interactions: the need for validated procedures. | Kremers P | — | 2002 | → |
| Schizophrenia and the motivation for smoking. | Forchuk C et al. | — | 2002 | → |
| Why does smoking protect against PONV? | Sweeney BP | — | 2002 | → |
| Differences in haloperidol epidemiologic pharmacokinetic studies. | Jann MW et al. | — | 2001 | → |