TY - JOUR AU - Wagner, Elias; Oviedo-Salcedo, Tatiana; Pelzer, Nicola; Strube, Wolfgang; Maurus, Isabel; Gutwinski, Stefan; Schreiter, Stefanie; Kleymann, Phillip; Morgenroth, Carla-Lou; Okhuijsen-Pfeifer, Cynthia; Luykx, Jurjen J.; Falkai, Peter; Schneider-Axmann, Thomas; Hasan, Alkomiet TI - Effects of Smoking Status on Remission and Metabolic and Cognitive Outcomes in Schizophrenia Patients Treated with Clozapine SN - 0176-3679 SN - 1439-0795 PY - 2020 JO - Pharmacopsychiatry JF - Pharmacopsychiatry LA - EN VL - 53 IS - 06 SP - 273 EP - 283 DA - 2020/08/05 KW - Clozapine KW - Schizophrenia KW - smoking KW - remission rates AB - Background Even though clozapine is the recommended last-resort antipsychotic, many patients fail to respond and show treatment-refractory psychotic symptoms. Smoking has been suggested as a possible risk factor for poor clozapine response, hampering remission and negatively impacting somatic outcomes.Methods Our aim was to test whether smoking status is associated with remission rates and other symptomatic and somatic outcomes. We therefore assessed remission rates according to The Remission in Schizophrenia Working Group (RSWG) criteria, and metabolic and cognitive outcomes among patients with schizophrenia-spectrum disorders treated with clozapine for at least 6 months. For analyses, we grouped our cohort into 3 groups according to clozapine treatment duration (6 months, 2 years, 5 years).Results One hundred five patients were included in our analyses and grouped according to their clozapine treatment duration. In the 6-months analyses, patients who smoked were significantly more likely to be younger of age (p=0.002) despite on average shorter duration of clozapine treatment (p=0.041) and significantly more likely to be treated with mood-stabilizing co-medication (p=0.030) compared to nonsmokers. Remission rates (p=0.490), as well as a set of metabolic and cognitive variables did not differ between the 2 groups. A related pattern could be observed for the 2- and 5-years analyses.Conclusions Smoking behavior among clozapine-treated schizophrenia patients might delineate a cohort with an earlier onset of the disease. Nevertheless, most findings comparing disease-specific and clinical outcomes among smokers and nonsmokers were negative. Further research is needed to identify strategies to overcome insufficient remission rates in this patient group. PB - Georg Thieme Verlag KG DO - 10.1055/a-1208-0045 UR - http://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-1208-0045 ER -