Smoking Therapy Helps, but With Side Effects

Smokers trying to kick the habit may have a new option for help. For smokers in whom standard therapy has failed, a combination therapy in a new study resulted in an increased cessation rate with little effect on withdrawal symptoms.

However, the combination caused frequent side effects including dry mouth and sedation. These effects caused a high rate of discontinuation, and participants treated required close monitoring.

In the study, 79 patients randomly received nortriptyline with transdermal nicotine and 79 patients randomly received a placebo. The cessation rates at six months were 23 percent for the treatment group and 10 percent for the placebo group.

Participants in the study smoked 10 or more cigarettes per day and did not have major depression. The nortriptyline hydrochloride or a placebo was started at 25 milligrams two weeks before they quitted. The dose was increased to 75 milligrams per day as tolerated and continued for three months after quit day. Then, 21 milligrams per day of transdermal nicotine was started on quit day and continued for eight weeks. Participants also had 12 brief behavioral intervention visits.

Current approaches to cessation are only partially successful, according to the study.

SOURCE: Archives of Internal Medicine, 2004;164:2229-2233