Double-blind placebo-controlled trial of fluoxetine in smoking cessation treatment including nicotine patch and cognitive-behavioral group therapy.
Smoking cessation attempts are often complicated by dysphoria/depression, weight gain, craving, and other nicotine withdrawal symptoms. Fluoxetine's antidepressant and anorectant properties, along with its capacity to attenuate compulsive behavior, suggest that this medication might facilitate smoking cessation treatment. We examined the effect of fluoxetine on smoking cessation in the context of a program that included group cognitive-behavioral therapy (six weeks) and transdermal nicotine patch(ten weeks). In a double-blind randomized trial of fluoxetine for smoking cessation, 150 daily smokers were assigned to placebo (n=48), 20 mg (n=51), or 40 mg fluoxetine (n=51). Fluoxetine did not significantly improve smoking cessation rates, either for those with or without major depressive disorder(MDD)histories or elevated current depression. Our results suggest that fluoxetine may moderate withdrawal symptoms, even if that was not manifested in improved smoking cessation rates. Our results, however, clearly favor the use of fluoxetine if weight gain is a major clinical obstacle to smoking cessation.
Saules
Karen K
KK
Substance Abuse Research Division, Department of Psychiatry and Behavioral Neurosciences, Wayne State University, School of Medicine, Detroit, MI, USA. ksaules@emich.edu
Schuh
Leslie M
LM
Arfken
Cynthia L
CL
Reed
Karen
K
Kilbey
M Marlyne
MM
Schuster
Charles R
CR
D000279:Administration, Cutaneous; D000328:Adult; D015928:Cognitive Behavioral Therapy; D003865:Major Depressive Disorder / Q000188:drug therapy; D004311:Double-Blind Method; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D005731:Ganglionic Stimulants / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D010078:Oxazines / Q000008:administration & dosage / Q000627:therapeutic use; D010919:Placebos; D011615:Psychotherapy, Group; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D016540:Smoking Cessation / Q000379:methods*; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy; D014029:Tobacco Use Disorder / Q000628:therapy*; D016896:Treatment Outcome; D015430:Weight Gain
D005473:Fluoxetine; D005731:Ganglionic Stimulants; D010078:Oxazines; D010919:Placebos; D017367:Selective Serotonin Reuptake Inhibitors; C050420:nicotone