Nortriptyline Tobacco

Nortriptyline is also considered to be efficacious as a second-line agent to treat tobacco dependence. Based on very limited data, the use of nortriptyline appears to increase abstinence rates when compared with placebo. 

Nortriptyline, a tricyclic antidepressant (TCA), is a non-selective norepinephrine reuptake inhibitor, and long-term abstinence outcomes are not significantly different from bupropion. However, only NRT and bupropion are currently approved by the FDA for the treatment of tobacco dependence. ... 

Smoking tobacco reduces the plasma levels of amitriptyline, clomipramine, desipramine, imipramine and nortriptyline, but this does not appear to result in a clinically significant interaction. 

Two studies found no difference between the steady-state nortriptyline plasma levels of tobacco smokers and non-smokers, but others have found that smoking tobacco lowers the plasma levels of amitriptyline, clomipramine, desipramine, imipramine" and nortriptyline. For example a 25% reduction in plasma nortriptyline levels was found in one study, and a 45% reduction in total levels of imipramine and its metabolite, desipramine, was found in another." ... 

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