Clinical Guidance: Nicotine Replacement During Emergency Stabilization of Schizophrenia
Agitated patients with schizophrenia in the emergency room who were smokers responded well to a 21-mg transdermal nicotine patch, in addition to regular antipsychotic treatment. Agitation was measured as excitement, hostility, tension, uncooperativeness, and poor impulse control. Effects were significant at 4 hours and were more marked in patients who were less nicotine dependent. Allen et al. (p. 395) speculate that the dose may have been too low for highly addicted patients. Schechter suggests in an editorial (p. 347) that nicotine replacement therapy in the emergency room might lessen agitation in smokers with other psychiatric disorders.