Consenso sobre o tratamento da dependência de nicotina

Marques, Andréa Grano; Campana, A. de Pádua; Gigliotti, Analice; Lourenço, Maria Helena; Ferreira, Montezuma Pimenta; Laranjeira, Ronaldo

doi:10.1590/s1516-44462001000400007

Cited by 60 publications

(111 citation statements)

References 124 publications

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“…Nicotine, a tertiary volatile amine, is the most important active tobacco component 4,6 . When tobacco coal's temperature reaches 800°C, racemic shapes of nicotine emerge, which form four nitrosamines with cancer potential 7 .…”

Section: Nicotine Pharmacologymentioning

confidence: 99%

“…The systemic actions of nicotine are mediated by nicotinic receptors found in the central nervous system (CNS), peripheral autonomic nodes, supra-renal glands, sensitive nerves and the skeletal striated muscle 4 .…”

Section: Nicotine Actionsmentioning

confidence: 99%

“…After a draft, the sensation may be compared to that described by amphetamine, heroine, cocaine and crack users 4 . The main sensations may include dizziness, nauseas and vomiting 10 .…”

Section: Nicotine Actionsmentioning

confidence: 99%

“…Nicotine induces tolerance (need of progressively higher doses to obtain the same effect) and dependence (desire of consumption) as it acts in the dopaminergic pathways of the mesolimbic system, reducing the thalamus activity 4 . Similarly to other psychoactive drugs, it releases dopamine in the nucleus accumbens, located in the mesencephalus, stimulating a pleasant and "rewarding" sensation 8,12 .…”

Section: Nicotine Chemical Dependencymentioning

confidence: 99%

“…It is estimated that 24% of the adult population in several countries, Brazil included, are nicotine dependent 4 .…”

Section: Introductionmentioning

confidence: 99%

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Métodos para abandono do tabagismo e tratamento da dependência da nicotina

Balbani

Montovani

2005

Rev. Bras. Otorrinolaringol.

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Smoki ng is related to 30% of cancer deaths. It is a risk factor for respiratory tract, esophagus, stomach, pancreas, uterine cervix, kidney and bladder carcinomas. Nicotine induces tolerance and addiction by acting on the central dopaminergic pathways, thus leading to pleasure and reward sensations within the limbic system. It stimulates the central nervous system (CNS), enhances alertness and reduces the appetite. A 50% reduction of nicotine consumption may trigger withdrawal symptoms in addicted individuals: anxiety, anger, sleep disorders, hunger, cognitive dysfunction and cigarette craving. Medical advice is the cornerstone of smoking cessation. Pharmacotherapy of nicotine addiction comprises first-line (bupropion and nicotine replacement therapy) and second-line (clonidine and nortriptyline) drugs. Bupropion is a non-tricyclic antidepressant that inhibits dopamine uptake, whose contraindications are: epilepsy, eating disorders, uncontrolled hypertension, recent alcohol abstinence and current therapy with MAO inhibitors. Nicotine replacement therapy can be done with patches or gums. Counseling groups and behavioral interventions are efficacious. The effects of acupuncture on smoking cessation are not fully elucidated. Prompt smoking cessation or gradual reduction strategies have similar success rates.

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Section: Nicotine Pharmacologymentioning

confidence: 99%

Section: Nicotine Actionsmentioning

confidence: 99%

“…After a draft, the sensation may be compared to that described by amphetamine, heroine, cocaine and crack users 4 . The main sensations may include dizziness, nauseas and vomiting 10 .…”

Section: Nicotine Actionsmentioning

confidence: 99%

Section: Nicotine Chemical Dependencymentioning

confidence: 99%

“…It is estimated that 24% of the adult population in several countries, Brazil included, are nicotine dependent 4 .…”

Section: Introductionmentioning

confidence: 99%

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Métodos para abandono do tabagismo e tratamento da dependência da nicotina

Balbani

Montovani

2005

Rev. Bras. Otorrinolaringol.

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The efficacy of the combination of sertraline with buspirone for smoking cessation

Carrão

Moreira

Fuchs

2007

Eur Arch Psychiatry Clin Neurosc

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In a double-blind placebo-controlled trial, we evaluated the efficacy of the combination of sertraline and buspirone plus cognitive-behavioral treatment to promote tobacco abstinence in individuals referred to a chemical dependency clinic. Ninety eight individuals 18-65 years of age were randomized to placebo or sertraline 25 mg/day for 2 days, followed by 50 mg from day 3 to 90, and buspirone 5 mg three times a day for 7 days, and 10 mg from day 8 to 90. The rate of continuous abstinence at the 26th week of follow-up, informed by the patient, was 43.5% in the active treatment group and 17.3% in the control group (p = 0.01). The odds ratio for continuous abstinence for the intervention group was 4.74 (95% CI 1.50-14.55) (adjusted for smoker households and number of cognitive sessions). Nicotine withdrawal symptoms were common in both groups (98.7% vs. 95.5% p = 0.37). The combination of sertraline and buspirone with cognitive-behavioral therapy was more effective than placebo and cognitive-behavioral therapy to promote smoking cessation.

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