title: Failure to improve cigarette smoking abstinence with transdermal selegiline + cognitive behavior therapy.
abstract: OBJECTIVE
  To examine the effectiveness of transdermal selegiline for producing cigarette smoking abstinence.
  
  
  METHODS
  Adult smokers were randomly assigned to receive selegiline transdermal system (STS) or placebo given for 8 weeks. All participants received cognitive behavior therapy (CBT). Follow-ups were conducted at 25 and 52 weeks.
  
  
  METHODS
  Community smoking cessation clinic.
  
  
  METHODS
  243 adult smokers (> or =18 years of age; > or =10 cigarettes/day).
  
  
  METHODS
  Expired-air carbon monoxide confirmed 7-day point prevalence abstinence.
  
  
  RESULTS
  STS was not superior to placebo. More women than men were abstinent at 52 week follow-up (28% vs 16%, P < 0.05). Behavioral activation (BAS) moderated treatment response (P = 0.01). The survival rate through week 52 for those with high 'drive' scores on the BAS was 47% if assigned to selegiline and 34% if assigned to placebo. The survival rate for those with low 'drive scores' on the BAS was 35% if assigned to selegiline compared to 53% if assigned to placebo.
  
  
  CONCLUSIONS
  Transdermal selegiline does not appear generally effective in aiding smoking cessation though there may be a selective effect in those smokers with low 'behavioral activation'.
authors: Departments of Medicine and Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA 94303-1334, USA. jkillen@stanford.edu
authors: Joel D
authors: JD
authors: Killen
authors: Stephen P
authors: SP
authors: Fortmann
authors: Greer M
authors: GM
authors: Murphy
authors: Chris
authors: C
authors: Hayward
authors: Dalea
authors: D
authors: Fong
authors: Kimberly
authors: K
authors: Lowenthal
authors: Susan W
authors: SW
authors: Bryson
authors: Diana T
authors: DT
authors: Killen
authors: Alan F
authors: AF
authors: Schatzberg
mesh_terms: D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D000368:Aged; D001521:Behavior Therapy; D001944:Breath Tests; D002248:Carbon Monoxide / Q000032:analysis; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D008996:Monoamine Oxidase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D009042:Motivation; D012008:Recurrence; D012044:Regression Analysis; D012642:Selegiline / Q000008:administration & dosage / Q000627:therapeutic use*; D017678:Sex Distribution; D012907:Smoking / Q000188:drug therapy* / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods*; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy; D014029:Tobacco Use Disorder / Q000188:drug therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D008996:Monoamine Oxidase Inhibitors; D012642:Selegiline; D002248:Carbon Monoxide