Psychiatr. praxi. 2016;17(3):88-91 | DOI: 10.36290/psy.2016.024

The most common cause of death of psychiatric patients: We should not be afraid to treat it

prof. MUDr. Eva Králíková, CSc.1,2, MUDr. Lenka Štěpánková, Ph.D.1, MUDr. Erika Kalinová3, MUDr. Zuzana Provazníková3, MUDr. Bc. Kristina Sadílková3
1 Centrum pro závislé na tabáku III. interní kliniky &ndash, kliniky endokrinologie a metabolizmu, 1. LF UK a VFN v Praze
2 Ústav hygieny a epidemiologie 1. LF UK a VFN v Praze
3 Psychiatrická nemocnice Bohnice

Smoking related diseases are the leading cause of death among psychiatric patients. Effective treatment for tobacco dependence exists: it involves both interventions aimed at changing smoking stereotypes and search for nonsmoking solutions in combination with pharmacotherapy. First-line drugs are nicotine replacement therapy, bupropion and varenicline, currently the most effective one. Among psychiatric patients, so far the fear of neuropsychiatric side effects prevented broader application of varenicline. However, they have now been definitively refuted EAGLES large study that involved more than 8,000 smokers, of whom over 4,000 with psychiatric diagnosis. The European Medicines Association on that basis decided to eliminate this warning from the package insert. Moreover, benefits of abstinence from smoking for prognosis and treatment of psychiatric disorders are repeatedly proven. Failure to provide evidence-based tobacco dependence treatment to psychiatric patients can now hardly be excused.

Keywords: smoking, tobacco dependence, psychiatric patient, treatment, varenicline, bupropione, neuropsychiatric adverse effects

Published: October 26, 2016  Show citation

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Králíková E, Štěpánková L, Kalinová E, Provazníková Z, Sadílková K. The most common cause of death of psychiatric patients: We should not be afraid to treat it. Psychiatr. praxi. 2016;17(3):88-91. doi: 10.36290/psy.2016.024.
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References

  1. Sovinová H, Csémy L. Užívání tabáku v České republice 2015, SZÚ 2016 http://www.szu.cz/uploads/documents/czzp/zavislosti/Uzivani_tabaku_2015.pdf.
  2. Talati A, Keyes KM, Hasin DS. Changing relationships between smoking and psychiatric disorders across twentieth century birth cohorts: clinical and research implications. Molecular Psychiatry (2016) 21, 464-471; http://www.nature.com/mp/journal/v21/n4/abs/mp2015224a.html. Go to original source...
  3. Williams JM, Stroup TS, Brunette MF, Raney LE. Tobacco use and mental illness: a wake-up call for psychiatrists. Psychiatr Serv. 2014; 65(12): 1406-1408. Go to original source...
  4. Fiore MC, Jaén CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. May 2008. http://www.ncbi.nlm.nih.gov/books/NBK63952/
  5. Kralikova E, Kmetova A, Stepankova L, Zvolska K, Davis R, West R. Fifty-two week continuous abstinence rates of smokers being treated with varenicline versus nicotine replacement therapy, Addiction, 2013; 108(8): 1497-1502. Go to original source...
  6. Lasser K, Boyd JW, Woolhandler S, Himmelstein DU, McCormick D, Bor DH. Smoking and mental illness: A population-based prevalence study. JAMA. 2000; 284(20): 2606-2610. Go to original source... Go to PubMed...
  7. Štěpánková L, Králíková E, Zvolská K, Kmeťová A, Anders M, Bortlíček Z, Blaha M, Štícha M. Depresivní porucha a úspěšnost léčby závislosti na tabáku, Česk a slov Psychiatr 2013; 109(2): 55-63.
  8. Patten CA, Bruce BK, Hurt RD, Offord KP, Richardson JW, Clemensen LR, Persons SM. Effects of a smoke-free policy on an inpatient psychiatric unit, Tob Control, 1995; 4: 372-379. Go to original source...
  9. Králíková E, Češka R, Pánková A, Štěpánková L, Zvolská K, Felbrová V, Kulovaná S, Zvolský M. [Tobacco dependence treatment guidelines]. Vnitr Lek. 2015; 61(5 Suppl 1): 1S4-1S15.
  10. Zevin S, Benowitz NL. Drug interactions with tobacco smoking. An update. Clin Pharmacokinet. 1999; 36(6): 425-438. Go to original source... Go to PubMed...
  11. Anthenelli RM, Benowitz NL, West R, St Aubin L, McRae T, Lawrence D, Ascher J, Russ C, Krishen A, Evins AE. Neuropsychiatric safety and efficacy of varenicline, bupropion, and nicotine patch in smokers with and without psychiatric disorders (EAGLES): a double-blind, randomised, placebo-controlled clinical trial. Lancet. 2016 Apr 22. pii: S0140-6736(16)30272-0. Go to original source...
  12. EMA - EPAR Summary for the Public, Champix, varenicline http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Summary_for_the_public/human/000699/WC500025252.pdf.
  13. Stepankova L, Kralikova E, Zvolska K, Pankova A, Ovesna P, Blaha M, BroseL. Depression and smoking cessation: Evidence from a smoking cessation clinic with 1-year follow-up, Ann Behav Med, v tisku.
  14. Taylor G, McNeill A, Girling A, Farley A, Lindson-Hawley N, Aveyard P. Change in mental health after smoking cessation: systematic review and meta-analysis. BMJ. 2014; 348: g1151. doi: 10.1136/bmj.g1151. Go to original source... Go to PubMed...




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