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Smoking behavior in clozapine-treated patients with schizophrenia

Key clinical point: Smoking behavior among clozapine-treated patients with schizophrenia may indicate earlier onset of the disease and significantly increases cardiovascular risk scores.

Major finding: Patients with schizophrenia who smoked were at risk of an earlier onset of treatment resistance, and thus were likely to receive clozapine at an earlier time point. At 6, 24, and 60 months, clozapine-treated patients who smoked had significantly higher Framingham Cardiovascular Disease Risk Prediction Scores (P = .002, P = .005, and P = .001, respectively) vs. nonsmokers.

Study details: A bicentric cross-sectional study including 105 patients (53 smokers and 52 nonsmokers) with schizophrenia-spectrum disorders treated with clozapine.

Disclosures: The study was a part of the MD thesis of Dr. Nicola Pelzer from the Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich. Dr. Wolfgang Strube received speakership compensation by Mag and More. Dr. Peter Falkai was an honorary speaker for and has been on the advisory board of multiple pharmaceutical companies. Dr. Alkomiet Hasan received paid speakerships and has been on the advisory board of multiple pharmaceutical companies. The remaining authors reported no conflicts of interest.


Wagner E et al. Pharmacopsychiatry. 2020 Aug 5. doi: 10.1055/a-1208-0045.