Notriptyline for smoking cessation: A review

ArticleinNicotine & Tobacco Research 7(4):491-9 · September 2005with5 Reads
Impact Factor: 3.30 · DOI: 10.1080/14622200500185298 · Source: PubMed


    This article reviews the efficacy of nortriptyline for smoking cessation based on a meta-analysis of the Cochrane Library.
    Six placebo-controlled trials have shown nortriptyline (75–100 mg) doubles quit rates (OR=2.1). Between 4% and 12% of smokers dropped out because of adverse events, but no serious adverse events occurred. The efficacy
    of nortriptyline did not appear to be related to its antidepressant actions. Nortriptyline is an efficacious aid to smoking
    cessation with a magnitude of effect similar to that for bupropion and nicotine replacement therapies. Whether nortriptyline
    produces serious side effects at these doses in healthy, nondepressed smokers remains unclear because it has been tested in
    only 500 smokers. The finding that nortriptyline and bupropion are effective for smoking cessation but that selective serotonin-reuptake
    inhibitors are not suggests that dopaminergic or adrenergic, but not serotonergic, activity is important for cessation efficacy.
    Until further studies can verify a low incidence of significant adverse events, nortriptyline should be a second-line treatment
    for smoking cessation.