Non-nicotine pharmacotherapies for nicotine dependence.
The smoking rate for patients with schizophrenia reaches as high as 90% in clinical samples, 70% for patients with bipolar disorder, and 40% to 50% for patients with major depression and anxiety disorders. Because it is a significant health hazard, smoking should be aggressively discouraged, and, in this group of patients, a combination of behavioral therapy and pharmacotherapy currently offers the best option. Nicotine provides a number of benefits, including anxiety relief, increased alertness, and improved cognitive functioning. It alters a wide range of central nervous system neurotransmitters. Unfortunately, nicotine readily establishes physiological dependence. In cessation efforts, transdermal nicotine patches and nicotine gum are helpful adjuncts. The primary FDA approved non-nicotine pharmacotherapy agent is bupropion (Zyban). Studies summarizing the effectiveness (or lack thereof) of other (off-label) agents, such as tricyclic antidepressants, MAO-Inhibitors, SSRIs, and clonidine, are cited.
Dudas
Melissa M
MM
Program for Research in Smokers with Mental Illness (PRISM), Connecticut Mental Health Center, New Haven, CT, USA.
George
Tony P
TP
D000928:Antidepressive Agents / Q000627:therapeutic use; D016642:Bupropion / Q000627:therapeutic use; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D004358:Drug Therapy; D006801:Humans; D009538:Nicotine / Q000627:therapeutic use; D014029:Tobacco Use Disorder / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology*
D000928:Antidepressive Agents; D016642:Bupropion; D009538:Nicotine