Pharmacotherapy of smoking cessation

Abstract

Nicotine in tobacco smoke causes not only pathophysiological changes in the smoker's body, but also develops tolerance to its own action with repeated use. Repeated exposure to nicotine develops neuroadaptation of the receptors, resulting in tolerance to many of the effects of nicotine. Pharmacotherapies for smoking cessation should reduce withdrawal symptoms and block the reinforcing effects of nicotine without causing excessive adverse effects. All forms of nicotine replacement therapy (NRT) – gum, patches and inhaler – and bupropion are safe and effective for increasing smoking cessation rates in the short and long-term use. Combination NRT (more than one therapy) may be indicated in patients who have failed monotherapy.

Relapse Rate and Factors Related to Relapse in a 1-Year Follow-Up of Subjects Participating in a Smoking Cessation Program

“…The presence of adverse effects was noteworthy, as the P value was close to significant after regression analysis, and it may be a factor affecting the success of pharmacotherapy indirectly. The reported adverse effects of varenicline, the most frequently prescribed agent used in our subjects, include the increased risk for cardiovascular accident development, 34 nausea, [35][36][37][38] abnormal dreaming, sleeplessness, 36,38 headache, 37,38 depression, and possible serious psychiatric conditions. 39,40 The most frequent adverse effect we observed with varenicline was nausea.…”

Seizure in a patient on Wellbutrin: a case report

“…1 Our patient is a smoker, so maybe this could be the reason wellbutrin was added to the medication regimen. Literature review revealed its effectiveness for clinical depression.…”

“…On monoamine oxidase receptors, it has no effects but it has minimal effects on serotonin receptors. 1 It is hard to distinguish if the cause of the seizure is drug-induced or due to some other reason. Generalized seizure is the type of seizure usually prevalent if the seizure is drug-induced.…”

A review of interventions for smoking cessation

“…Bupropion is thought to inhibit noradrenaline and dopamine reuptake in effecting an antidepressant effect, which is thought to be important in aiding smoking cessation (43). Nortriptyline is a tricyclic antidepressant (44) and is the cheapest option (45), although unavailable in Sri Lanka.…”