Preliminary Study for the Effect of No-smoking on Antipsychotics, Benztropine and Propranolol Dosage for Re-admitted Psychotic Patients / 신경정신의학

ABSTRACT

This study was designed to investigate the effect of no-smoking on the pattern of medication for 30 re-admitted psychotic patents in the no-smoking(smoking-prohibited) ward, who had been admitted and medicated previously in the smoking (smoking-allowed) ward, in Wonju Christian Hospital, by comparing daily mean dosage of antipsychotics, benztropine mesylate, and propranolol administered in smoking state and in no-smoking state of the same patients. The results were as follows 1) The mean hospital stay was reduced to 46.0 days in no-smoking ward compared to 61.1 days in smoking-allowed ward. This means mean admission period was reduced significantly(p<0.05) and over two thirds of all subjects experienced reduction of hospital stay from 2 days to 92 days. 2) A statistically significant difference was fecund in the dosage of antipsychotics in all subjects. Calculated in terms of chlorpromazine equivalent, the daily mean was 296.8+/-180.7mg in no-smoking state, and 395.0+/-232.2mg in smoking state(p<.01), 3) In schizophrenics(n=13), the daily mean dosage of benztropine mesylate was 0.56+/-.62mg in no-smoking state and 0.14+/-0.21mg in smoking state, showing a significant difference(p<.05). In bipolar group, the mean dosage in no-smoking ward was also smaller than in smoking ward, though not significant. 4) The difference of the daily mean dosage of propranolol between two states was not significant. In conclusion, in no-smoking state psychotic patients required less hospital stays and significantly lower dosage of antipsychotics, and the schizophrenics required significantly higher dosage of benztropine mesylate for extrapyramidal symptoms. The authors suggest that psychiatric patients should be encouraged to stop smoking and recommend that psychiatrists monitor smoking state of their psychotic patients for proper and efficient drug therapy.