Failure to improve cigarette smoking abstinence with transdermal selegiline + cognitive behavior therapy.
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'.
Killen
Joel D
JD
Departments of Medicine and Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA 94303-1334, USA. jkillen@stanford.edu
Fortmann
Stephen P
SP
Murphy
Greer M
GM
Hayward
Chris
C
Fong
Dalea
D
Lowenthal
Kimberly
K
Bryson
Susan W
SW
Killen
Diana T
DT
Schatzberg
Alan F
AF
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
D008996:Monoamine Oxidase Inhibitors; D012642:Selegiline; D002248:Carbon Monoxide