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"It's a useful mode of delivery, though its desirability and frequency of prescription will depend on the disorder," commented Dr. Jeffrey Lieberman, chairman of psychiatry at Columbia University.

Alexza Pharmaceuticals Inc. is currently at work on inhalable drugs for pain, anxiety and schizophrenia-induced agitation. While other companies have produced inhaled drugs before — particularly for respiratory disorders like asthma — Alexza is the first to experiment with "smokable" varieties.

Inhaled drugs are much faster acting than pills, because the medicine passes through the lungs and into the blood within seconds, rather than having to be digested and absorbed. Alexza's smokable drugs involve heating liquid drugs to create a vapor. Unique about this idea is the company's intention to create a portable delivery device, so that patients can carry their medication anywhere they go. Alexza is currently testing a hip-flask-sized, battery-powered package.

The company is furthest along with testing a smokable version of nausea medicine called prochlorperazine, which Alexza hopes to develop into a medicine for migraine headaches. It plans to release its mid-stage clinical trial results before April and file a marketing application by 2010. According to CEO Thomas King, the company also hopes to announce a partnership with a major pharmaceutical or device company to start developing another drug by the end of the year.

Lieberman expressed doubt about the efficacy of an inhaled drug for schizophrenic agitation, but was more positive about its use by anxiety patients. "People with panic disorder want immediate relief and would be very cooperative," he said. "They know that if they take a pill it can take up to an hour to work. This would be a non-stigmatizing way to deal with the situation."

Alexza was started by Alejandro Zaffaroni, the same businessman who founded the pharmaceutical company Alza. Alza was the first company to develop the nicotine patch.

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