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Review: bupropion and nortriptyline each increase smoking cessation rates

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 Q Do antidepressants increase long-term abstinence from smoking?

Clinical impact ratings GP/FP/Primary care ★★★★★★☆ IM/Ambulatory care ★★★★★☆☆ Respirology ★★★★★★☆

METHODS

Embedded ImageData sources:

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.

Embedded ImageStudy 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.

Embedded ImageOutcomes:

smoking abstinence at ⩾6 months.

MAIN RESULTS

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 …

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