title: Nicotine-mecamylamine treatment for smoking cessation: the role of pre-cessation therapy.
abstract: The nicotinic antagonist mecamylamine was evaluated in a randomized smoking cessation trial. Four groups of participants (n = 20 per group) received nicotine plus mecamylamine, nicotine alone, mecamylamine alone, or no drug for 4 weeks before cessation. After the quit-smoking date, all subjects received nicotine plus mecamylamine treatment for 6 weeks. Nicotine skin patches (21 mg/24 hr) and mecamylamine capsules (2.5-5.0 mg twice per day) were used. Precessation mecamylamine significantly prolonged the duration of continuous smoking abstinence; abstinence rates at the end of treatment were 47.5% with mecamylamine and 27.5% without mecamylamine. Nicotine + mecamylamine reduced ad lib smoking, smoking satisfaction, and craving more than either drug alone. Moreover, the orthostatic decrease in blood pressure caused by mecamylamine was offset by nicotine. Mecamylamine before smoking cessation may be an effective adjunct to nicotine patch therapy.
authors.affiliation: Nicotine Research Program, Veterans Affairs Medical Center, Durham, North Carolina 27705, USA. jerose@acpub.duke.edu
authors.forename: J E
authors.initials: JE
authors.lastname: Rose
authors.forename: F M
authors.initials: FM
authors.lastname: Behm
authors.forename: E C
authors.initials: EC
authors.lastname: Westman
mesh_terms: D000328:Adult; D000339:Affect; D001521:Behavior Therapy; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008464:Mecamylamine / Q000008:administration & dosage*; D009538:Nicotine / Q000008:administration & dosage*; D018722:Nicotinic Agonists / Q000008:administration & dosage*; D009657:North Carolina; D016540:Smoking Cessation / Q000379:methods*; D013997:Time Factors; D014029:Tobacco Use Disorder / Q000523:psychology / Q000628:therapy*
chemical_list: D018722:Nicotinic Agonists; D008464:Mecamylamine; D009538:Nicotine