Psychological Intervention and Antidepressant Treatment in Smoking Cessation

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Abstract
THE ANTIDEPRESSANTS bupropion hydrochoride and nortriptyline hydrochloride are useful adjuncts in the treatment of tobacco dependence. A multicenter bupropion trial reported 1-year continuous abstinence rates of 24% for 300 mg/d, 18% for 150 mg/d, 14% for 100 mg/d, and 10% for placebo. The difference from placebo was significant in the 150- and 300-mg/d groups.1 A trial comparing bupropion and nicotine patch reported 1-year continuous abstinence rates of 36% for bupropion and nicotine patch, 33% for bupropion alone, 16% for nicotine patch alone, and 15% for placebo. Bupropion alone or with nicotine patch resulted in significantly higher abstinence rates than did patch alone or placebo.2 Our group reported 1-year continuous abstinence rates of 24% for nortriptyline and 12% for placebo.3 A second study reported that 14% of patients receiving nortriptyline and 3% of patients receiving placebo were abstinent 6 months after treatment.4