Mental illness linked to cigarette addiction

[Alfa]

Mental illness linked to cigarette addiction

Posted: July 15, 2008

Dr. R. Andrew Chambers is an assistant professor of psychiatry at the Indiana University School of Medicine.

Question: Do mental illnesses and cigarette addiction go hand in hand?

Answer: That's correct. One recent study documents that up to 50 percent of cigarettes are smoked by people with some form of mental illness. This includes schizophrenia, bipolar disorder, major depression, anxiety disorders, post-traumatic stress disorder, borderline personality disorder.

In the general population, the smoking rate is between 20 and 25 percent, depending on where you live. In schizophrenia, the smoking rate is 75 to 90 percent. Alcoholism is about 80 percent. Bipolar disorder is 60 to 70 percent, and major depression is 40 to 50 percent.

Q: Why is there a link between smoking and nicotine addiction?

A: The traditional theory is that people are self-medicating and they're receiving some kind of benefit from the nicotine. There is evidence out there that nicotine in certain circumstances does have cognitive-enhancing effects or might be a modulator of mood or anxiety.

Another theory is that people with mental illness are more susceptible to the disease of addiction. There's quite good evidence for that because you also see addictions with many other drugs, such as cannabis, cocaine and alcohol. It may be that nicotine is just a not-so-unique example of a broader picture.

There's a third cutting-edge perspective that nicotine can change the brain, especially in adolescents. In 90 percent of smokers, smoking begins between 15 and 25, when the brain is undergoing a lot of changes. Nicotine exposure in that period can change the brain chemistry in a way that may make you more susceptible to mental illness.

Q: So are different smoking cessation methods recommended for the mentally ill?

A: That is being looked at. Self-medication is the most popular theory, but ironically the least validated. If you label it self-medication, the label does not acknowledge that they're addicted, and when clinicians go along with that, they're sort of rationalizing the drug use.

The cultures of mental health care and addiction-ology are segregated. That creates huge problems. Most of our patients who need mental health care have an addiction of some kind. Yet we have an amazing inability to effectively treat those addictions.

Chantix, the newest drug for smoking addiction, appears to be very effective. When that drug was developed, the trials excluded people with mental illness. It got approved and the drug shows efficacy, but now we're finding out this drug has all kinds of implications for people with mental illness.

What I'm arguing for is for psychiatrists to be trained in addiction. But that's a long way off.

http://www.indystar.com/apps/pbcs.dl.../1300/LIVING25

[stoneinfocus]

Nicotine also induces CYP3A4 enzymatic pathways, so that butyrophenone neuroleptics are faster metabolized and I don't know of anyone who likes this sort of medication.
Also, nicotine, as the short Dopamine-push it provides, might be used for learning and therefor by intelligent people, e.g. Wernherr von Braun or others, who where heavy smkokers, among with the widespread use of cigarettes in the general population, this is some far-fetched statement, that had to be validated, among any other thesis of psychiatry, like genetic predeposition, etc. , it's just all more assumption, than science, much more, than in any other medical field. Sounds like penis-envy from sides of the psychiatrist, imho.

and -to add a little more to those speculation, what were the consequences of takin' this (smoking as a co-morbidity to mental illness) as a, more-or-less, valid assumption?

I. It was just another far-fetched symptom to validate a maybe far-fetched illness, and even a very often found habit in the general public.

II. Smoking cigarettes is something legal to do, so they don't have to rely on illegal activities, like smoking cannabis was illegal and going about an legal issue was itself a sign of mental illness, along with some mind-alterning effect.

Conclusion: Taken together, those approaches to validify mental deseases are becoming more and more a danger to the civil rights of selfdetermination and the uniqueness of an individuum in its right to differ from the mainstream; the practice of psychiatry and psychology are such, that, already, it's very easy to diagnose nearly any human with a mental desease; and all that, on grounds of half-assed assessments of individual habits, that might fail to relate those habits to the lifestyle and forcing enviromental causes, which led the individuum take-on to those habits, to compensate for its own lifestyle in this society and the sanity's sake of its nature in it.

What's next? -excessive sporting, which is not soccer? Being not obese? Being without a job? Not drinkiong red wine every forthnight? Selfmedication? Society is approaching the latter conclusions, thanks to psychiatry, in huge steps and it's us all to see the inevitable danger, that emerges from the "issue" psychiatry and its ways of diagnosing.

The worst thing one can do to a human life, imho, is commanding societies' institutions to help humans, when there's absolutely nothing to "help," on basis of numerous half-validated symptoms, in the delusion the mere flood of questionable diagnostic sings were making them more valid and trustworthier, but which are all far away from the duty of very exact conventional scientific validation, which are only valid when the very same results have been achieved by any other scientific third party around the world under the same conditions.
(Ever heard i.e. Shulgin, stating; "the meltingpoint is 15°C off, but I declare it's the correct substance, because other signs are just the same measure off, like those 15° in m.p.?)
The line between helping and dictature becomes then non-existant.

Reputation Comments on this post:

whoa there buddy, that's an overload of info for my feeble brain

[ShawnD]

Looks like another bullshit article from a doctor who sucks at being a doctor.

Originally Posted by Alfa

Q: Why is there a link between smoking and nicotine addiction?

Is this even a real question? Asking why smoking leads to a nicotine addiction? Come on, we're told in elementary school why smoking is addictive.

A: The traditional theory is that people are self-medicating and they're receiving some kind of benefit from the nicotine. There is evidence out there that nicotine in certain circumstances does have cognitive-enhancing effects or might be a modulator of mood or anxiety.

And the sky is blue, you say? Let's check to see if random internet people already knew this. wiki - nicotine

Originally Posted by wikipedia

By binding to CNS type nicotinic receptors, nicotine increases dopamine levels in the reward circuits of the brain. In this way, it activates the reward system and generates feelings of pleasure.

Fascinating.

Another theory is that people with mental illness are more susceptible to the disease of addiction. There's quite good evidence for that because you also see addictions with many other drugs, such as cannabis, cocaine and alcohol. It may be that nicotine is just a not-so-unique example of a broader picture.

Oh, so when people are addicted to the dopamine from cocaine and amphetamine, that's actually the same as dopamine associated with nicotine? And you say that mentally ill people are more interested in drugs? I'm absolutely shocked. Let's check if the internet already knew this. wiki - bipolar disorder

Originally Posted by wikipedia

Mania [...] Judgment may become impaired; sufferers may go on spending sprees or engage in behavior that is quite abnormal for them. They may indulge in substance abuse, particularly alcohol or other depressants, cocaine or other stimulants, or sleeping pills.

Damn, the internet is now 2/2. Doctor is 0/2.

There's a third cutting-edge perspective that nicotine can change the brain, especially in adolescents. In 90 percent of smokers, smoking begins between 15 and 25, when the brain is undergoing a lot of changes. Nicotine exposure in that period can change the brain chemistry in a way that may make you more susceptible to mental illness.

oh mah gawd, wait until I tell the internet about this! wiki - nicotine

Originally Posted by wikipedia

It functions as an antiherbivore chemical, being a potent neurotoxin

You mean neurotoxins damage the brain? Holy crap why doesn't med school teach this??? Oh, right, they do. He just didn't feel it was important to actually listen to what the lecturer was saying.

Q: So are different smoking cessation methods recommended for the mentally ill?

Fact: No.
wiki - bupropion (Wellbutrin)

Originally Posted by wikipedia

Initially researched and marketed as an antidepressant, bupropion was subsequently found to be effective as a smoking cessation aid. In 2007 it was the fourth-most prescribed antidepressant in the United States retail market, with 20.184 million retail prescriptions.

So not only is this widely known in the research field, but it's widely known by GP's and psychiatrists who are writing these 20 million prescriptions.

A: That is being looked at. Self-medication is the most popular theory, but ironically the least validated. If you label it self-medication, the label does not acknowledge that they're addicted, and when clinicians go along with that, they're sort of rationalizing the drug use.

Worst statement in the history of the world. Prescription medications that "medicate" often have a warning about drug dependence or "addiction". To say that the two are thought of as mutually exclusive is beyond stupid since drug labels themselves contradict that train of thought.

The cultures of mental health care and addiction-ology are segregated. That creates huge problems. Most of our patients who need mental health care have an addiction of some kind. Yet we have an amazing inability to effectively treat those addictions.

Even a 5 year old can figure out that the addiction will not go away until the mental illness itself is treated. This is why Wellbutrin (antidepressant) is given out to overcome smoking addictions; treating the underlying depression (relating to dopamine) will ease the "drug-seeking behavior" (google that term). This is also why partial dopamine agonists are being looked at in the treatment of cocaine and amphetamine addictions.


Terrible article: 0/10

[sarbanes]

You always hear those in the state loony bin are chronic smokers. Many a man doing the "Thorazine Shuffle" will have hands stained from cigarette smoke. Perhaps (because) it is one of the few vice allowed them (alcohol certainly not allowed). Just like in NA meeting, it is the one thing allowed. Maybe that factors into the association as well, but more on an environmental level.

[Expat98]

Dr. R. Andrew Chambers is an assistant professor of psychiatry at the Indiana University School of Medicine.

Question: Do mental illnesses and cigarette addiction go hand in hand?

Answer: That's correct. One recent study documents that up to 50 percent of cigarettes are smoked by people with some form of mental illness.

You know what I like about this interview? The guy makes a completely ludicrous statement at the very beginning of it. Saves me from wasting my time reading the whole thing!

On second thought, I guess professional psychologists have defined so many types of mental illnesses and have defined them so broadly that easily 50% or more of the general population can be considered to have "some form of mental illness". So he may in fact be technically correct, but in this case, it's a meaningless statement.

[ShawnD]

Originally Posted by Expat98

On second thought, I guess professional psychologists have defined so many types of mental illnesses and have defined them so broadly that easily 50% or more of the general population can be considered to have "some form of mental illness".

psychtruth - are you normal?

That asshole in the video blocked me because I kept calling him out on his bullshit, but he has a point in this one.

[lostmente]

anyone been to a public psyche ward here? swim has been once...upwards of 80% of patients were smokers...when they were able to that is

lostmente added 9 Minutes and 11 Seconds later...

having a form of mental illness requires diagnosis, this requires doing something to get a diagnosis (either forced or voluntary..)

granted the number of people put on SSRI's is outrageous...it certainly works...but mostly in a capacity sense so its up to the patient to work with that new capacity...if they fill it with the same bullshit that got them there in the first place then yeah it becomes systemic

[enquirewithin]

Obviously, according to this research, if you smoke cigarettes, you are 50% more likely to become psychotic.

[lostmente]

when was it new news that psychoactives can cause structural changes in the key periods of neurological development.
SWIMSSA

[stoneinfocus]

Originally Posted by sarbanes

You always hear those in the state loony bin are chronic smokers. Many a man doing the "Thorazine Shuffle" will have hands stained from cigarette smoke. Perhaps (because) it is one of the few vice allowed them (alcohol certainly not allowed). Just like in NA meeting, it is the one thing allowed. Maybe that factors into the association as well, but more on an environmental level.

And it (nicotine) makes thorazine go out of your system quicker ;-)

[ShawnD]

Come to think of it, my friend, who was a bouncer at a night club, did say something to the effect of "all smokers are heat bags". By that he meant that people smoking outside of the club were always sketchy people that one would expect to cause trouble or be loud and obnoxious. Mental illness would sure explain his observations.

[ShawnD]

I stumbled across an article that was too funny not to share, and it sort of relates to this!

Encyclopedia Dramatica - Abnormal Psychology

Thank you for taking the time to learn more about mental illness here on Encyclopedia Dramatica. Mental illness is a serious condition affecting at least 100% of all Americans in a given year; this figure rises dramatically on the Internets, where two in three people are mentally ill. Some have attributed the rise of mental illness to angst-ridden emos who turn every little quirk into a big disease to effect drama. Whatever the case, there is an estimated eighty-five (85) percent chance you are mentally ill

It's supposed to be a joke, but it's actually somewhat true how these labels get started. Own an iPod? You might have Apple Fanboy Personality Disorder. This increases your risk of smoking addiction by over 9000%

[some_random_guy]

Interesting find/read man thanks.

[bcubed]

anyone been to a public psyche ward here? swim has been once...upwards of 80% of patients were smokers...when they were able to that is

Yes, I have. I'll back up the statements about the prevalence of smoking. As someone who had zero interest in smoking anything they'd allow into a psych ward, I felt I was at an advantage...the staff (mostly RNs) had a real "hook" into the smokers, as 1. There was no smoking on ward and 2. You needed their blessing to obtian the "privleges" necessary to leave the ward.

Note this:

There's a third cutting-edge perspective that nicotine can change the brain, especially in adolescents. In 90 percent of smokers, smoking begins between 15 and 25, when the brain is undergoing a lot of changes. Nicotine exposure in that period can change the brain chemistry in a way that may make you more susceptible to mental illness.

And this:

Chantix, the newest drug for smoking addiction, appears to be very effective. When that drug was developed, the trials excluded people with mental illness. It got approved and the drug shows efficacy, but now we're finding out this drug has all kinds of implications for people with mental illness.

Note the reflexive (and most likely unconscious) view of the "official" drug (i.e prescription) as begnign and an unqualified benefit, and the "unofficial" drug as a wreaker of mental havoc. I've seen this firsthand: when describing withdrawing from Seroquel (Quetiapine) in solitary in jail, I (smart-assedly) said "Sorry, doc--I meant to say 'rebound.' 'Drugs' cause 'addiction' and one 'suffers withdrawl'; 'medications' lead to 'tolerance' and one might 'experience rebound!'

Not so much as a smirk--he truly believed what I threw out as a joke! There might be exceptions, but MDs, as a class, are almost incapable of self-critical reflection, esp. whan the person asking that they do so lacks an MD himself.

[Mr. Giraffe]

Makes sense to me that cig smokers are self-medicating in the same way mentally ill cannabis smokers are. Nicotine does have cognitive benefits and anecdotal evidence suggests that schizophrenics find it helpful.

I notice that doctors and researchers seem to have become more eager to prostitute their professional reputations to sensationalist claims about drugs. I can only assume that they believe we are so stupid that we need to have the truth simplified, exaggerated and then spoon-fed to us in unequivocal headlines.

[stoneinfocus]

Which is a kind of flawed itself, isn't dopamine supposed to exaggerate the symptoms of mental illnesses, like shizophrenia, so actually one had to say cigarette smoking causes mental illnesses?

*LMAO* at Mr. Giraffe, bcubed and ShawnD

stoneinfocus added 11 Minutes and 14 Seconds later...

Originally Posted by ShawnD

Come to think of it, my friend, who was a bouncer at a night club, did say something to the effect of "all smokers are heat bags". By that he meant that people smoking outside of the club were always sketchy people that one would expect to cause trouble or be loud and obnoxious. Mental illness would sure explain his observations.

Smoking is some form of self-hatred drug use, -you know it's damaging, your first cigarette makes your knees weak, it's bad, you get a bad breath and are coughing all the time, miore likely to get any other infections... so this could well be a metaphor for some social hate those people had to bear and are expressing it this way.

[cra$h]

obviously there's going to be a link. Cigarettes are used as a quick way to relax, and anyone who's going to have some kind of anxiaty, is going to be prone to the quick fix smoking gives. It's really not that scientific.

[Richard_smoker]

Apparently, this is the gist of what some researchers from Toronto, published in the Journal of Molecular Psychiatry:

For decades, research has shown that dopamine, a neurotransmitter, is responsible for the rewarding effects of nicotine. But researchers could never explain why people with schizophrenia on dopamine-blocking drugs tend to smoke like chimneys.
It didn't seem to make sense: if dopamine allowed the brain to enjoy smoking and dopamine was blocked, smoking should no longer be a pleasurable experience.
"And what was the surprising thing was the rewarding effects were not blocked at all," Laviolette said of the rat experiments.

In fact, the contrary was true, he said. Blocking dopamine blocked the adverse effects of nicotine, but ramped up the rewarding sensations induced by the drug. Dramatically. The findings suggest that schizophrenia medications that block dopamine are fixing one problem but causing another, he said.

"What's really happening is that you're blocking dopamine in the schizophrenics, you're increasing nicotine's rewarding effects. And that's why you see 95 per cent of schizophrenics are heavily addicted to nicotine."

Reputation Comments on this post:

Great posts, well searched, major contibution, thanks you!

[ShawnD]

But researchers could never explain why people with schizophrenia on dopamine-blocking drugs tend to smoke like chimneys.
It didn't seem to make sense: if dopamine allowed the brain to enjoy smoking and dopamine was blocked, smoking should no longer be a pleasurable experience.

Are those the most retarded researchers on the planet, or are they just not aware of how humans behave?

Most people take drugs until they reach a certain level of satisfaction, such as me drinking 2 beers, or a friend smoking 1 cigarette. Drinking 10 beers would be too many, and smoking 5 cigarettes would be too many. People with clinical depression will need more drugs to get the same level of satisfaction, such as alcoholics, cocaine addicts, chain smokers, etc. When someone is given dopamine antagonizing drugs, it will obviously take a lot more drugs to get the same reward from a dopamine boosting activity. For a schizophrenic taking Seroquel, this means smoking 5 cigarettes at once instead of just 1.

If you want more information about how this works, try googling things that are related to depression, drug abuse, or alcoholism; use those specific terms.

Reputation Comments on this post:

That makes sense to me.

[msmogadon]

Originally Posted by lostmente

anyone been to a public psyche ward here? swim has been once...upwards of 80% of patients were smokers...when they were able to that is

SWIMs a psychiatric nurse and can vouch for this, perhaps more even than 80%. SWIM has also been a patient in a psych ward and is a non-smoker. She started smoking roll ups as she wanted a joint to chill but had no access to weed at the time. There was also NOTHING to do all day so at least this was SOMETHING to do.

[Richard_smoker]

shawnD, that's not what they're referring to...sorry, I took the liberty to edit down the actual article, but I did so, apparently, at the expense of the article's content.

I'll have to find the original to re-quote exactly, but what the researchers found is that cigarette smoking has both POSITIVE effects (rewards) and NEGATIVE effects, mentally...their hypothesis was, essentially, that in people who take anti-psychotics (anti-dopamine drugs), the effect with regard to cigarette smoking is that the NEGATIVE effects of nicotine were BLOCKED!!!

See??

I'm not sure about the validity of this conclusion...but I do know that there is definitely a known association between the looney-bin and cigarettes...

MY APOLOGY IN ADVANCE FOR QUOTING HERESAY-->i know a nurse practitioner who SWEARS that nicotine is a self-medication tool that allows schizophrenics to regulate their own dopamine excess...i don't know the exact mechanism, but maybe it was MAGIC! no. seriously...we should look this up.

[Panthers007]

So the "Schizophrenic-Brain" model is the Rat-In-Cage that keeps pulling the lever for the banana. There is no downside to the nicotine's effect on the dopamine-centers. Just continuous pleasurable stimuli involved.

[Richard_smoker]

Panthers--yeah, that's how I interpret it....and it would certainly explain the continuous pattern of asking any and all healthcare workers, "hey man, give me a cigarette...i know you have some."


Some Cigarette/Smoking and Schizophrenia Findings:

--abnormal electro-physiological and eye-tracking deficits can be normalized by cigarette smoking or nicotine administration (Olincy et al. 1998).

--Smoking, at least partially, alleviates neuroleptic-induced extra-pyramidal side effects (Sandyk 1993).

--Nicotine increases the metabolism of haloperidol (Haldol), requiring patients that smoke to take higher doses than non-smoking schizophrenics, often further increasing their smoking behavior (McEvoy et al. 1995).

Interestingly, clozapine, which does not induce the motor dysfunctions (extrapyramidal effects) seen with typical neuroleptics, clozapine actually reduces smoking behavior and normalizes the electrophysiological deficit in schizophrenics (Nagamoto et al. 1996).

Previous results have shown that the high affinity neuronal nicotinic receptors were up regulated in hippocampus and thalamus of subjects that smoke, compared to nonsmokers (Breese 1997). This increase was both dose-dependent and reversible. The present results extend these findings to cortex, a region sensitive to the regulatory effects of chronic nicotine treatment in rodents (Marks 1985), and caudate, a region with a high density of dopaminergic terminals.

In subjects with no history of mental illness, a significant increase in nicotinic receptor binding in these brain regions was seen in smokers compared to either nonsmokers or smokers who had quit. The increases were also correlated with packs smoked per day, further demonstrating the dose-dependency of nicotinic receptor up-regulation in human brain. Nicotinic receptor binding in smokers who had quit was comparable to nonsmokers, showing the reversibility of nicotinic receptor up-regulation in these brain regions when tobacco use is discontinued (Breese 1997).

Scatchard analysis further indicated that these changes were related to changes in receptor number since the binding affinity of the neuronal nicotinic receptors was not changed as a result of smoking history (Breese 1997).

In the present study, schizophrenic subjects did not demonstrate the same regulatory responses for the high affinity neuronal nicotinic receptors as seen in control smokers. Schizophrenics who smoked demonstrated an overall reduction in the normal up-regulation of high
affinity neuronal nicotinic receptors in most brain regions examined. While basal binding levels were not different between control and schizophrenic subjects, the reduction in high affinity nicotinic receptor binding
in schizophrenic smokers was observed in group means, as well as in the regression analysis. The slope of the regression line, based on nicotinic receptor binding and number of cigarettes smoked per day, was reduced up to 60% in schizophrenic subjects, indicating a failure to up-regulate the high affinity neuronal nicotinic receptors at any given smoking level compared to controls. Scatchard analyses suggested that the changes seen in nicotinic receptor levels were due to changes in total receptor numbers (Bmax) and not to a change in receptor affinity (Kd).

Since schizophrenics are primarily treated with drugs that block dopaminergic neurotransmission, it was of interest to examine brain regions with dopaminergic innervation, namely striatum and cortex. In this study, caudate was examined as a representative region of striatum for measuring changes in high affinity neuronal nicotinic receptor binding in control smokers and schizophrenic subjects. Caudate, as well as cortex, showed a reduced level of nicotinic receptor upregulation in schizophrenics, compared to control subjects, suggesting that cholinergic modulation of dopaminergic neurotransmission might be affected in schizophrenia (Pidoplichko 1997).

It is also interesting to note that schizophrenics demonstrated age related changes in neuronal nicotinic receptor numbers in both cortex and hippocampus, whereas control subjects demonstrated changes only in the cortex.

Previous results suggest that schizophrenics may have a loss of cognitive function (Heinrichs 1998), and an accelerated loss of nicotinic cholinergic receptors with age would be consistent with this finding. The failure of up-regulation of the nicotinic receptors in smoking schizophrenics was not expected.

Approximately 80% of schizophrenics smoke, compared with 20 to 30% of the general population (Leon et al. 1995), and it has been shown that schizophrenics extract a greater amount of nicotine from each cigarette smoked compared to control subjects (Olincy et al. 1997).

While a number of factors should be considered as possible mechanisms for the aberrant regulation of nicotinic receptor levels in schizophrenic brain, the use of neuroleptic medication was a primary concern, as the postmortem tissue used in the present study was primarily from subjects receiving typical neuroleptic medication in life. Therefore, haloperidol was used to assess the effect of chronic neuroleptic and nicotine treatment on nicotinic receptor levels in rat cortex.

Rats treated with the typical neuroleptic haloperidol had the same level of [

3H]-nicotine binding as saline control animals in cortex, indicating that haloperidol alone had no effect on nicotinic receptor expression. Combination treatment with haloperidol and nicotine induced similar increases in nicotine binding as nicotine treatment alone. Further studies have indicated similar results in other rat brain regions (Lee et al. 1998).

Interestingly, schizophrenics failed to show any upregulation in thalamus from baseline levels. In thalamus, upregulation in response to nicotine can be reduced and variable, particularly at low doses of nicotine, indicating that thalamus may be refractory to nicotinic receptor upregulation. While neuroleptic treatment may have affected receptor upregulation of the high affinity receptors in thalamus, the lack of correlation may be related to the expression of other receptor subtypes (Marks et al. 1992) that do not demonstrate the same degree of receptor upregulation to chronic nicotine treatment as the a4b2 subtype (Fenster et al. 1999).

To fully explain the present results in schizophrenics, the basis of the paradoxical increase in the neuronal nicotinic receptors in normal human smokers must be known. While it could be hypothesized that the nicotinic

receptors are not desensitized in schizophrenics and therefore fail to upregulate, data showing a transient effect of nicotine on the normalization of the abnormal auditory gating response in schizophrenics do not support this hypothesis (Adler et al. 1992, 1993). Nevertheless, schizophrenics could have an abnormality in any of several potential mechanisms that change the desensitization state of the receptor and receptor turnover, as well as activation and ion flux through the receptor.

Whatever the mechanism for the reduced levels of both high and low affinity nicotinic receptors in schizophrenics, the resultant reduced nicotinic cholinergic modulation may induce several secondary effects. There is strong evidence that a large component of nicotinic receptor function involves presynaptic receptor activation (MacDermott 1999), and as such would be expected to play an important role as a modulator of numerous neurotransmitter systems. The nicotine-stimulated release of multiple types of neurotransmitters is well-documented.

In addition, nicotinic autoreceptors are thought to function at motor-nerve terminals, where they regulate acetylcholine release. This may occur in the brain as well.

Presynaptic receptors in brain also appear to regulate the release of GABA. A possible regulatory relationship between different nicotinic receptor classes involving inhibition of GABA release in hippocampus has been suggested. It is interesting to speculate that the decreases in both low and high affinity nicotinic receptor binding seen in schizophrenia might reflect altered receptor subunit ratios in brain, resulting in aberrant inhibitory modulation.

Considering the widespread localization of the neuronal nicotinic receptors and their potential role in modulating numerous neurotransmitter systems in both the brain and periphery, characterization of the nicotinic receptor gene family in schizophrenia and its relationship to the inhibitory deficits and pharmacological medications used in this disease may further the investigation of synaptic modulation in human brain and provide new avenues for treatment.

From: Abnormal Regulation of High Affinity Nicotinic Receptors in Subjects with Schizophrenia.

Breese, et al. Neuropsychopharmacology 23:351–364, 2000

Interestingly they mention nicotine's effect on GABA transmission, only in the last paragraph...GABA is an inhibitory neurotransmitter. i.e. GHB is a metabolic product of GABA, & benzodiazepines have an overall GABA-effect.

Here's something to consider...if the nicotine-supplemented brain, while resting (i.e. between cigarettes) had an enhanced GABA flow, this would lead to a calmer, relaxed thought-stream...

I imagine this would be a welcome addition to any schizo's day.

-DICK

[Expat98]

There probably is some type of link between cigarette smoking and mental illness. But to suggest that mental illness is the main factor in determining whether someone smokes or not is erroneous. The main factor in determining whether someone smokes is the culture in which he lives.

The U.S. used to have a much higher percentage of smokers than it does now. Does this mean that mental illness levels in the U.S. have dramatically declined? Of course not. It just means that the culture changed.

In many countries today, particularly developing countries, there is still a very high percentage of the population who smoke. Does this mean that these countries have much higher levels of mental illness than the U.S.? No, it primarily means that smoking is viewed differently in these countries.

That's why it's ridiculous to say that, "up to 50 percent of cigarettes are smoked by people with some form of mental illness," as stated in the article above.

[Alfa]

Dick. Please change your font. It is too small to read.