10006429 J Clin Psychiatry / Document Archive

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The article you requested is

Dr. Haller and Colleagues Reply

J Clin Psychiatry 1997;58:179 [letter]
Copyright 1997 Physicians Postgraduate Press, Inc.

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Letter to the Editor

Sir: Dr. Pearlman states that “paranoid and psychotic patients addicted to nicotine who refuse nicotine patches are prone to aggressive acting out behavior,” yet he does not provide data to support this statement. We do not doubt that some patients who refuse nicotine gum or patches may become agitated as part of the nicotine withdrawal syndrome. In the DSM-IV, the diagnosis of nicotine withdrawal requires at least four of the following signs: “dysphoric or depressed mood; insomnia; irritability, frustration, or anger; anxiety; difficulty concentrating; restlessness or impatience; decreased heart rate; and increased appetite or weight gain.”