Related Experiment Video
Updated: Jul 17, 2026
08:15
Network Pharmacology and Validation of the Antidepressant Mechanisms of Qiangzhifang in a Chronic Restraint Stress-induced Depression Rat Model
Published on: June 6, 2025
Antidepressants for smoking cessation.
J R Hughes1, L F Stead, T Lancaster
1University of Vermont, Department of Psychiatry, 38 Fletcher Place, Burlington, Vermont 05401-1419, USA. john.hughes@uvm.edu
The Cochrane Database of Systematic Reviews
|January 27, 2007
Summary
Antidepressants bupropion and nortriptyline effectively aid long-term smoking cessation, doubling cessation odds. Selective serotonin reuptake inhibitors do not show significant long-term benefits for quitting smoking.
Area of Science:
- Pharmacology
- Addiction Medicine
- Clinical Trials
Background:
- Antidepressants may aid smoking cessation by alleviating nicotine withdrawal symptoms or by directly affecting neural pathways of nicotine addiction.
- Theoretical mechanisms include relieving depressive symptoms, substituting nicotine's antidepressant effects, or blocking nicotine receptors.
Purpose of the Study:
- To evaluate the efficacy of various antidepressant medications in achieving long-term smoking cessation.
- Included medications: bupropion, doxepin, fluoxetine, imipramine, moclobemide, nortriptyline, paroxetine, sertraline, tryptophan, and venlafaxine.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs) comparing antidepressant pharmacotherapy to placebo or alternative treatments.
- Searched Cochrane Tobacco Addiction Group trials register up to September 2006.
- Main outcome: smoking abstinence at ≥6 months follow-up, using odds ratios (OR) and fixed-effect models.
Main Results:
- Bupropion (OR 1.94) and nortriptyline (OR 2.34) significantly increased odds of long-term smoking cessation when used as sole pharmacotherapy.
- No additional long-term benefit observed when bupropion or nortriptyline were added to nicotine replacement therapy (NRT).
- Selective serotonin reuptake inhibitors (SSRIs) like fluoxetine, sertraline, and paroxetine showed no significant long-term cessation benefit.
Conclusions:
- Bupropion and nortriptyline are effective antidepressants for long-term smoking cessation, comparable in efficacy to NRT.
- Their mechanism of action appears independent of their antidepressant properties.
- SSRIs are not effective for long-term smoking cessation based on available evidence.
Related Concept Videos
01:23Antidepressant Drugs: MAOIs and Other Agents
Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
01:28Antidepressant Drugs: Tricyclics, SSRIs, and SNRIs
Tricyclic Antidepressants (TCAs), including Desipramine (Norpramin), Imipramine (Tofranil), Clomipramine (Anafranil), and Amitriptyline (Elavil), inhibit serotonin and norepinephrine reuptake and also block other receptors. They are used for depression, pain conditions, and insomnia. Common adverse effects include anticholinergic effects, sedation, orthostatic hypotension, and weight gain. They have a narrow therapeutic window and so require plasma-level monitoring. Abrupt discontinuation can...
01:27CNS Depressants: Alcohol and Nicotine
Ethanol, a clear colorless alcohol, has been consumed by humans for millennia, but its effects on the body are far from benign. At lower doses, it induces decreased inhibitions and loquaciousness, leading to its social appeal. However, it can cause severe consequences at higher doses, such as coma and respiratory depression, due to its zero-order elimination kinetics. Chronic ethanol abuse wreaks havoc on multiple organ systems, particularly the CNS and the liver. Abrupt cessation of ethanol...
01:25Antidepressant Drugs: Overview
Antidepressant drugs are a class of medications primarily used for treating various mood disorders, including major depression, anxiety disorders, and other related conditions. These medicines work by modulating the neurotransmitter balance within the brain, alleviating depressive symptoms. Antidepressants can be broadly categorized into several groups according to their mechanism of action and chemical structure: Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin-Norepinephrine...
01:17Sedatives and Hypnotics Drugs: Miscellaneous Agents
Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
01:17Drug Dependence
Medications are typically administered to achieve therapeutic effects. Some drugs can modify an individual's mood and perception, frequently resulting in various enjoyable experiences. However, this can result in drug dependency, a condition marked by continuous drug use despite potential negative consequences. Drug dependency primarily falls into two categories: psychological and physical dependence. Psychological dependence occurs when the pleasurable feelings induced by the drug...