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Sao Lucas Hospital - School of Medicine PUCRS, Porto Alegre, Brazil
PURPOSE: Compare the efficacy of nortriptyline and bupropion for smoking cessation.
METHODS: We conducted a double-blind, double-dummy, placebo-controlled comparison of nortriptyline (52 subjects), sustained-release bupropion (53 subjects) and placebo (51 subjects) for smoking cessation. Smokers with clinical depression were excluded. Treatment consisted of nine weeks of nortriptyline (25mg a day for the first five days, and than 75mg a day) or bupropion (150mg a day for the first five days, and than 150 mg twice daily) or placebo. The target day for quitting smoking was usually day 10.
RESULTS: The abstinence rates at 6 months were 21.6 percent in the placebo group, as compared with 30.8 percent in the nortriptyline group (OR 1,62; IC95% 0,61-4,33; p=0.40), and 41.5 percent in the bupropion group (OR 2,58;IC95% 1,01-6,71; p=0.05). There was a not statistically significant difference between nortriptyline and bupropion (OR 1.60, IC95% 0.66-3.86, p=0.35). The most common adverse events were dry mouth and drowsiness in the nortriptyline group and dry mouth and insomnia in the bupropion group.
CONCLUSION: Treatment with sustained-release bupropion resulted in a significantly higher long-term rates of smoking cessation than placebo. Abstinence rates were higher with bupropion than nortriptyline, but the difference was not statistically significant.
CLINICAL IMPLICATIONS: Nortriptyline can be a alternative drug to help people to stop smoking.
DISCLOSURE: F.M. Haggstram, None.
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