Antidepressant Seems to Help Smokers Quit

However, it produces side effects like dry mouth, drowsiness, study finds

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WEDNESDAY, Nov. 10, 2004 (HealthDayNews) -- The antidepressant drug nortriptyline, when used with a nicotine patch, may help smokers kick the habit.

Researchers from the University of Colorado Health Sciences Center offer that assessment in the November issue of the Archives of Internal Medicine.

The study included a group of 79 people who received nortriptyline and another group of 79 people who received a placebo. Both groups started with 25 milligrams per day of either the drug or the placebo 14 days before the date set for them to stop smoking. The doses were then increased to 75 milligrams per day, as tolerated.

All the study participants were given a transdermal nicotine patch on the day they quit smoking. All of them continued to use nicotine patches for eight weeks.

Six months after the quit day, smoking-cessation rates were 23 percent for those taking nortriptyline and 10 percent for those taking the placebo. There was no reduction in withdrawal symptoms in either group.

The people in the nortriptyline group had much higher rates of side effects such as dry mouth and drowsiness. Due to these adverse effects, nortriptyline was discontinued in 13 percent of the people taking it.

"There are several possible mechanisms of action for nortriptyline's effect in enhancing smoking cessation. Nortriptyline may reduce depressive symptoms and the need for 'negative effect smoking.' Other antidepressant agents are also effective in smoking cessation, suggesting that the antidepressant effect may be the common mechanism," the study authors wrote.

"It is also clear from our data that subjects treated with nortriptyline require close monitoring for adverse events. However nortriptyline combined with transdermal nicotine may prove to be a useful alternative for smokers in whom first-line smoking cessation therapies have failed," the authors concluded.

More information

The American Cancer Society has more about quitting smoking.

SOURCE: JAMA/Archives journals, news release, Nov. 10, 2004


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