An important characteristic of nicotine is that it has a wide variety of pharmacological actions that go beyond simple addictiveness. Some of its effects, such as those on cognition, can be beneficial, despite the variety of other adverse health consequences of tobacco use. Groups who smoke most heavily such as patients with schizophrenia may be engaging in self-medication with nicotine. Improvement in Memory Deficits Schizophrenia patients have been found by Dr. Robert Freedman and his group at the University of Colorado to have a deficiency of nicotinic receptors in the hippocampus, an area of the brain important in attention to new sensory stimuli and memory formation. At Duke University Medical Center, Drs.
Haloperidol causes a dose-related increase in ad lib smoking.
Patients with schizophrenia may smoke at high rates to both treat the cognitive symptoms of schizophrenia and to alleviate the adverse side effects of classic antipsychotic drugs. Certainly we are not advocating cigarette smoking in patients with schizophrenia. Cigarette smoking has a variety of health impairing effects. However, nicotine delivered by other means, such as nicotine skin patches, may be useful for treating some of the cognitive symptoms of schizophrenia and cognitive deficits which result from antipsychotic medication. To date, the only FDA approved general use for nicotine skin patches is to help people quit smoking.