Changes in cigarette consumption in psychiatric patients: Impact on side-effects or the efficacy of clozapine and olanzapine

Subodh Jain, Jatinder M. Chawla, Thimmaiah G. Theethira, Martin Strassnig, K. N.Roy Chengappa

Research output: Contribution to journalComment/debatepeer-review

3 Scopus citations


Indications:1 patient with paranoid schizophrenia. Coexisting disease: cigarette smoking addiction.

Patients:One 47-year-old female Caucasian outpatient.

TypeofStudy:A case report describing the elevation of Leponex blood levels resulting to side effects following cessation of cigarette smoking in a patient with paranoid schizophrenia.

DosageDuration:750 mg daily bid for 11 years, and then reduced to 650 mg daily.

Results:One month following cessation of smoking, the patient remained stable with regard to her psychiatric symptoms but complained of hypersalivation, extreme fatigue and daytime somnolence. Leponex and norclozapine levels were elevated at 1083 and 816 ng/ml respectively. Leponex dose was reduced to 700 mg daily. 8 weeks after smoking cessation, no re-emergence of psychiatric symptoms was noted, and while sedation reduced slightly, no improvements were observed in daytime somnolence, hypersalivation or fatigue. Leponex dose was further reduced to 650 mg.

AdverseEffects:1 patient had weight gain at initial 2 years and was treated with diet and exercise; and hypersalivation, extreme fatigue, and daytime somnolence after smoking cessation.

FreeText:The patient with a 30-year history of paranoid schizophrenia (positive and negative symptoms) was eventually stabilized 11 years ago on Leponex. She started smoking cigarettes at the age of 15 years. 5 months earlier, she developed pneumonia and started to quit smoking. Tests: Leponex and norclozapine blood levels.

Original languageEnglish (US)
Pages (from-to)324-326
Number of pages3
JournalActa Neuropsychiatrica
Issue number6
StatePublished - Dec 2008

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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