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Q Do antidepressants increase long-term abstinence from smoking?
Clinical impact ratings GP/FP/Primary care ★★★★★★☆ IM/Ambulatory care ★★★★★☆☆ Respirology ★★★★★★☆
Drug names found in the Cochrane Tobacco Addiction Group’s specialized register, reference lists, recent reviews, and meeting abstracts were searched in PubMed and EMBASE/Excerpta Medica (March 2004). Investigators were contacted as needed.
Study selection and assessment:
randomised controlled trials (RCTs) that compared any antidepressant with placebo or another treatment and assessed smoking abstinence at ⩾6 months. Studies were pooled using fixed effects.
smoking abstinence at ⩾6 months.
36 RCTs met the selection criteria. Tricyclic antidepressants. Nortriptyline increased smoking cessation; when added to nicotine replacement therapy (NRT), nortriptyline did not increase abstinence rates more than NRT alone (see table at www.evidence-basedmedicine.com). Monoamine oxidase inhibitors. Moclobemide did not show a statistically significant difference in abstinence at 12 months (see table at …
For correspondence: Professor J Hughes, University of Vermont, Burlington, VT, USA.
Sources of funding: National Institute on Drug Abuse and NHS Research and Development Programme.