Smoking is associated with the induction of the CYP 1A2 enzyme, and hence with diminished levels of drugs metabolized by this enzyme. This article presents a hypothetical patient, diagnosed with schizophrenia, who smokes about 10 cigarettes a day. The progress of the patient is examined across several follow up meetings, each of which presents a fresh clinical problem related to smoking and its interaction with the medication. Clinical guidance for each problem is presented along with a brief discussion on the subject. The article concludes with a discussion of other pharmacokinetic considerations related to smoking and its treatment in patients with schizophrenia.
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