Buspirone effect on tobacco withdrawal symptoms: a pilot study

Tobacco withdrawal symptoms hamper smoking cessation. This was a pilot study of buspirone, a new azapirone anxiolytic, for tobacco withdrawal. Thirteen smokers entered an open clinical trial. Smokers were titrated to 30 mg/day of oral buspirone for 2 weeks prior to cessation. Tobacco withdrawal and Spielberger state-anxiety scales were used at baseline, on the quit date, and then at 24 hours, 48 hours, 1 week, and 2 weeks after abrupt cessation. At the final visit, smokers compared their withdrawal experience with previous cessation attempts. Two patients (15 percent) could not tolerate the medication and did not attempt smoking cessation. Of the remaining 11 smokers, 3 (27 percent) rated withdrawal relief "very definite," 6 (55 percent) "moderate," and 2 (18 percent) "slight." More than two-thirds of the smokers believed that their difficulty concentrating, craving, restlessness, and anxiety were improved compared with earlier tobacco withdrawal attempts. Five patients (46 percent) reported decreased smoking urges during the 2-week medication titration period. Tobacco withdrawal symptoms and state-anxiety scores changed significantly during the study (P less than 0.05). These results are encouraging, but they should be interpreted with caution because of the small sample size and lack of placebo control. Buspirone effect on tobacco withdrawal symptoms should be studied in a randomized, controlled clinical trial.