Cessation treatments

Addington J, el-Guebaly N, Campbell W, et al Smoking cessation treatment for patients with schizophrenia. Am J Psychiatry 135 974-976, 1998 American Psychiatric Association Practice Guideline for the Treatment of Patients With Substance Use Disorders, 2nd Edition. Washington, DC, American Psychiatric Association (in press)... 

Briggs G, Freeman R, Yaffe S Drugs in Pregnancy and Lactation A Reference Guide to Maternal and Fetal Risk. Philadelphia, Lippincott, Williams Wilkins, 2002 Chengappa KN, Kambhampati R, Perkins K, et al Bupropion sustained release as a smoking cessation treatment in remitted depressed patients maintained on neatment with selective serotonin reuptake inhibitor antidepressants. J Clin Psychiatry 62 503—508, 2001... 

Kalman D, Hayes K, Colby SM, et al Concurrent versus delayed smoking cessation treatment for persons in early alcohol recovery a pilot study. J Subst Abuse Treat 20 233-238, 2001... 

Niaura R, Spring B, Borrelli B, et al Multicenter trial of fluoxetine as an adjunct to behavioral smoking cessation treatment. J Consult Clin Psychol 70 887-896, 2002... 

Lerman, C.R.D., Kaufmann, V., Audrain, J., Hawk, L., Liu, A., Niaura, R., Epstein, L. Mediating mechanisms for the impact of bupropion in smoking cessation treatment. Drug Alcohol Depend. 67 219, 2002. 

Near-normal glycemia reduces the risk of microvascular disease complications, but aggressive management of traditional cardiovascular risk factors (i.e., smoking cessation, treatment of dyslipidemia, intensive blood pressure control, antiplatelet therapy) is needed to reduce macrovascular disease risk. 

Bupropion sustained release (SR) is an effective smoking-cessation treatment. It is contraindicated in patients with a seizure disorder, a current or prior diagnosis of bulimia or anorexia nervosa, and use of a monoamine oxidase inhibitor within the previous 14 days. It can be used in combination with NRT. 

Clonidine, delivered transdermally or orally, is an effective smoking-cessation treatment. It is given for 3 to 10 weeks and should not be discontinued abruptly. Abrupt discontinuation may cause nervousness, agitation, headache, tremor, and rapid rise in blood pressure. 

Depression Bupropion (immediate release) IR, Wellbutrin (sustained release) SR, and bupropion (extended release) XL are indicated for the treatment of depression. Smoking cessation (Zyban only) Indicated as an aid to smoking-cessation treatment. 

On cessation, treatment should be tapered slowly. A proportion of patients have significant withdrawal symptoms to antidepressants on tapering that respond to the reinstitution of treatment. At present there is no known treatment for the physical dependence linked to antidepressants when severe other than gradual tapering. 

NDRi (norepinephrine dopamine reuptake inhibitor) antidepressant smoking cessation treatment... 

For smoking cessation, treatment for up to 6 months has been found effective... 

Rose, J. E. (1991). Transdermal nicotine and nasal nicotine administration as smoking cessation treatments. In J. A. (k)cores (Ed.), The clinical management of nicotine dependence (pp. 196-207). New York Springer-Verlag. 

Since ischemic heart disease and/or hypertension contribute so significantly to the development of heart failure in the majority of patients, it is important to emphasize that heart failure is a largely preventable disorder. Thus recent evidence that obesity and salt intake are important risk factors for heart failure is not surprising. Moreover, control of blood pressure and appropriate management of other risk factors for cardiovascular disease (e.g., smoking cessation, treatment of lipid disorders, diabetes management, dietary modification, etc.) are important strategies for clinicians to implement to reduce their patients risk of heart failure. 

Clonidine, a prescription drug, is an efficacious smoking cessation treatment. It may be used under a clinician s supervision as a second-line agent to treat tobacco dependence. A recent meta-analysis of six trials showed that clonidine increased smoking cessation rates by 11% (OR 1.89 Cl 1.30 to 2.14). There was a high incidence of dose-dependent side effects, particularly dry mouth and sedation. It should be noted that abrupt discontinuation of clonidine can result in symptoms such as nervousness, agitation, headache, and tremor, accompanied or followed by a rapid rise in blood pressure and elevated catecholamine levels. 

McClure JB, SkaarK, Tsoh J, etal. Smoking cessation treatment 3 Needed health care policy changes. Behav Med 1997 23 29-34. 

Fagerstrom K. Smoking cessation treatment with sustained released bupropion optimizing approaches to management. Drugs SuppI 2002 62 1-70. 

Wellbutrin and Zyban (an aid in smoking cessation treatment) are trade name products for bupropion. Therefore, the potential exists for an overdose toxicity in a patient receiving multiple brand name and generic prescriptions containing bupropion for the treatment of depression, smoking cessation, and other off-label uses. 

A successful pharmacotherapeutic approach is cutaneous nicotine patch combined with Zyban (welbutrin) as an aid to smoking cessation treatment (174). This pharmacological combination should be continued for at least 6 months. 

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