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Related Experiment Videos

Antidepressants for smoking cessation.

J Hughes1, L Stead, T Lancaster

  • 1Department of Psychiatry, University of Vermont, 38 Fletcher Place, Burlington, Vermont 05401-1419, USA.

The Cochrane Database of Systematic Reviews
|October 21, 2004
PubMed
Summary
This summary is machine-generated.

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Bupropion and nortriptyline significantly increase long-term smoking cessation success rates. Selective serotonin reuptake inhibitors, however, do not appear to aid smokers in quitting.

Area of Science:

  • Pharmacology
  • Addiction Medicine
  • Clinical Trials

Background:

  • Antidepressants may aid smoking cessation by alleviating nicotine withdrawal-induced depressive symptoms or by substituting for nicotine's mood-altering effects.
  • Alternatively, some antidepressants might act on neural pathways involved in nicotine addiction, independent of their antidepressant properties.

Purpose of the Study:

  • To evaluate the efficacy of various antidepressant medications in achieving long-term smoking cessation.
  • To assess the effectiveness of bupropion, doxepin, fluoxetine, imipramine, moclobemide, nortriptyline, paroxetine, sertraline, tryptophan, and venlafaxine for smoking cessation.

Main Methods:

  • Systematic review of randomized controlled trials comparing antidepressant pharmacotherapy with placebo or alternative treatments for smoking cessation.

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  • Included trials with at least six months of follow-up, assessing abstinence, relapse prevention, and smoking reduction.
  • Meta-analysis was performed using a fixed-effect model for pooled data.

    • Main Results:

    • Bupropion and nortriptyline demonstrated significant efficacy, doubling the odds of long-term smoking cessation when used as monotherapy.
    • Selective serotonin reuptake inhibitors (SSRIs) like fluoxetine, sertraline, and paroxetine showed no significant benefit in smoking cessation.
    • Limited evidence suggested bupropion combined with nicotine patch might offer a slight advantage, but this was not consistently replicated. Extended bupropion therapy for relapse prevention did not yield significant long-term benefits.

    Conclusions:

    • Bupropion and nortriptyline are effective antidepressants for aiding long-term smoking cessation.
    • The efficacy of these specific antidepressants suggests their mechanism of action in smoking cessation is likely independent of their antidepressant effects, as SSRIs were ineffective.