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Question by ॐ Plea for Peace!: why do a lot of schizophrenics like to smoke cigarettes and drink coffee?
i’ve read that something like 90% of schizophrenics smoke cigarettes, and i’ve also heard that a large percentage drink a lot more coffee than those considered normal.

does anyone have any ideas? the smoking i can understand if it’s an obsessive behavior, but i wonder if the nicotine in cigs or the caffeine in coffee has anything to do with it?

Best answer:

Answer by gardensallday
I think I read recently that they have an inability to experience pleasure normally, and cigarettes fill that need. I don’t know about the coffee. I will say that I drink a hell of a lot of coffee & I have bipolar. Oh wait, found this on schizohprenia.com:

Scientists find link for smoking, schizophrenia – Schizophrenia Update, January 2004

A team of Toronto researchers has made a startling discovery about why people with schizophrenia are so much more likely than other people to be smokers.

Medications that block dopamine – commonly used by people with this debilitating condition – make smoking a more rewarding experience, they reported in the journal Molecular Psychiatry.

The findings, which challenge long-held views about the role of dopamine in nicotine addiction, may provide science with clues on how to help schizophrenics and others give up cigarettes and kick other habit-forming drugs.

“It’s a first step in identifying systems in the brain that can mediate vulnerability to addiction,” said lead author Steve Laviolette, who is currently doing post-doctoral research at the University of Pittsburgh.

He admitted, however, that the findings are likely to spark controversy.

“It’s basically overturning 30 years of previous research. So you might come across people who are hostile to – if not shocked by – the results.”

Yavin Shaham, an addiction researcher at the U.S. National Institute on Drug Abuse in Baltimore, Md., agreed that the findings defy some of the dogma around nicotine addiction. But he said the science is sound and the findings will spark debate in the addiction research community.

“I think that it’s very interesting research that points in new directions to understanding nicotine reward,” said Shaham, who was not involved in the research.

“It’s not necessarily the way we thought about it in the past. And it’s certainly relevant for the understanding of why schizophrenics are smoking so much.”

Laviolette wrote the paper with co-author Derek van der Kooy while working on his doctorate in neuropharmacology at the University of Toronto. The pair was trying to identify areas in the brain that are involved in nicotine addiction.

“The schizophrenic angle came up almost accidentally, really,” Laviolette said from Pittsburgh.

The work, done on rats, involved injecting nicotine or a placebo – in this case saline – directly into a portion of the brain known as the ventral tegmental area, or VTA. The VTA is thought to be the pleasure centre of the brain and is known to be involved in nicotine, alcohol and drug addiction.

To the team’s surprise, they discovered the VTA also is involved in aversion. Low doses of nicotine administered to that area of the brain actually induced a negative reaction from the rats. It was only when the dosage crossed a certain threshold that the animals began to perceive it as pleasurable and to seek it out.

“That was surprising, that a single brain area was responsible for both the aversive and the rewarding effects,” Laviolette admitted.

More surprising still was what happened when they gave the rats drugs that blocked the dopamine receptors in the VTA.

For decades, research has shown that dopamine, a neurotransmitter, is responsible for the rewarding effects of nicotine. But researchers could never explain why people with schizophrenia on dopamine-blocking drugs tend to smoke like chimneys.

It didn’t seem to make sense: if dopamine allowed the brain to enjoy smoking and dopamine was blocked, smoking should no longer be a pleasurable experience.

“And what was the surprising thing was the rewarding effects were not blocked at all,” Laviolette said of the rat experiments.

In fact, the contrary was true, he said. Blocking dopamine blocked the adverse effects of nicotine, but ramped up the rewarding sensations induced by the drug. Dramatically.

The findings suggest that schizophrenia medications that block dopamine are fixing one problem but causing another, he said.

“What’s really happening is that you’re blocking dopamine in the schizophrenics, you’re increasing nicotine’s rewarding effects. And that’s why you see 95 per cent of schizophrenics are heavily addicted to nicotine.”

Further, the same effect is probably happening with alcohol and possibly other drugs, Laviolette said.

“It’s a two-edged sword. The drug is removing the psychosis but at the same time making them addicted to these extremely dangerous drugs.”

Not all medications used to treat schizophrenia work by blocking dopamine, however. The newer generation of medications, known as atypical anti-psychotic drugs, work by a different mechanism.

Laviolette said the research suggests that the reactions to a drug induced in the VTA fall on a spectrum from aversion to pleasure. Whether one finds a cigarette satisfying or disgusting may depend on one’s baseline dopamine levels, he said.

and another article with another explanation:
Scientists have found that smoking and schizophrenia are tightly linked, but are not sure why. Could nicotine actually be helping the disorder? If so, then it is a double-edged sword, because smoking is a life-threatening behavior.

Now, new research on the effects of nicotine in people with schizophrenia is beginning to answer these questions and uncover clues that may help to treat this serious disorder.

Schizophrenia is characterized by disordered thinking; hallucinations, such as hearing voices; and delusions, such as paranoid beliefs that people are conspiring against you. Schizophrenia affects about 1 percent of the population and places a substantial burden on those afflicted, their families, and society.

Many people with schizophrenia smoke, and their unique smoking behaviors have led scientists to believe that nicotine, the addicting substance in tobacco, may represent a form of self-medication, normalizing some central nervous system deficits involved in the disorder.

People with schizophrenia smoke up to three times more than the general population and more than most psychiatric populations. Schizophrenia patients who smoke also have higher levels of nicotine in their bodies because they tend to extract more nicotine per cigarette than other smokers.

Nicotine and its brain receptors—proteins on the surface of cells that receive chemical messages—are keys to understanding the links between smoking and schizophrenia. Already, research has revealed that:

Nicotine and its receptors are involved in functions such as cognition or thinking ability, reward, movement, and pain relief.
Schizophrenia patients have fewer and more poorly functioning nicotinic receptors, especially in the hippocampus, cortex, and cells that wrap the thalamus—brain areas involved in several cognitive and sensory deficits of schizophrenia.
Increased nicotine intake—from smoking cigarettes or sometimes from a skin patch, gum, or nasal spray—may temporarily normalize sensory disruptions of schizophrenia. For example, nicotine may improve eye tracking abnormalities, mostly by altering activity in the hippocampus and brain areas involved in eye movement. Nicotine also has been reported to improve the brain’s ability to filter sounds and to respond and adapt to strong sensory inputs.

Cognitive ability in people with schizophrenia may get a boost from nicotine as well, including temporary enhancements in learning, memory, processing speed, and attention. Several studies have examined spatial working memory—the ability to hold information in the brain and recall it when prompted. Spatial working memory is involved in planning, judgment, and attention—tasks that people with schizophrenia find difficult. Schizophrenia patients who smoked or who received nasal spray nicotine temporarily enhanced their spatial working memory, and those who quit had further impairments.

Smoking also may help decrease medication side effects and other symptoms of schizophrenia. According to one study, receiving nicotine through a skin patch reversed the cognitive slowing associated with haloperidol, a common drug for schizophrenia. Nicotine may improve lack of motivation and indifference in this population, as well. However, it remains unclear if nicotine minimizes hallucinations and delusions, and some studies have reported that people with schizophrenia who quit smoking did not experience worsening of their symptoms.

Nicotine may help lessen some symptoms of schizophrenia by increasing deficient levels of the chemical dopamine—which is thought to regulate key emotional responses—in areas of the brain such as the nucleus accumbens and prefrontal cortex. The nucleus accumbens is involved in reward and pleasure, and the prefrontal cortex organizes complex cognitive and social behaviors.

Since evidence shows that nicotine positively affects schizophrenia, scientists are exploring drugs that act like nicotine in the brain but do not have adverse health consequences. Researchers now are working on safer and less toxic drugs that potentially could enhance cognition. These drugs may help treat schizophrenia.

One type of nicotinic receptor, known as the alpha-7 receptor, is proving to be a major target for schizophrenia drug development. These receptors are found in brain regions important for cognition, including the cortex and hippocampus. Already, scientists have completed preliminary tests of drugs for schizophrenic nonsmokers based on a toxin, called anabaseine, found in marine worms and ants. Subjects showed improved sensory processing and cognition, especially attention.

Scientists continue to research the biology and function of different nicotinic receptors. As knowledge advances, so will development of new and safer drugs to help treat s

Answer by nat
they probably lilke the effect the stimulants have on them.

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