Smoking cessation clonidine

Despite the limitations imposed by the physiology of the skin, several marketed controUed release transdermal dmg dehvery systems are available in the United States for example, scopolamine [51-34-3] for the treatment of motion sickness, nitroglycerin [55-63-0] for angina, estradiol [50-28-2] for the rehef of postmenopausal symptoms and osteoporosis, clonidine [4205-90-7] for the treatment of hypertension, fentanyl [437-38-7] as an analgesic, and nicotine [54-11-5] as an aid to smoking cessation. These systems are designed to dehver dmg for periods of one to seven days. 

Covey LS, Classman AH A meta-analysis of double-blind placebo controlled trials of clonidine for smoking cessation. Br J Addict 86 991—998, 1991 Covey LS, Classman AH, Stetner F Naltrexone effects on short-term and long-term smoking cessation.] Addict Dis 18 31 0, 1999 Covey LS, Sullivan MA, Johnston A, et al Advances in non-nicotine pharmacotherapy for smoking cessation. Drugs 39 17-31, 2000 Dani JA, De Biasi M Cellular mechanisms of nicotine addiction. Pharmacol Biochem Behav 70 439 46, 2001... 

Glover ED, Leischow SJ, Rennard SI, et al A smoking cessation trial with lobeline sulfate a pilot study. Am J Health Behav 22 62-74, 1998 Gourlay SG, Benowitz NL Is clonidine an effective smoking cessation therapy Drugs 50 197-207, 1995... 

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. 

Alternative pharmacological approaches Clonidine, an o2 adrenergic agonist, has been employed as adjunctive therapy to assist in smoking cessation. However, results have been mixed or the effects small (Gourlay et al. 1994 Hilleman et al. 1993 Franks et al. 1989). Buspirone (BuSpar) is a 5-HTlA partial agonist with anxiolytic effects. It has been tested as a treatment for smoking cessation because anxiety is a prominent feature of nicotine withdrawal (Farid and Abate 1998). To date, results have been mixed and more controlled research is needed. 

Franks FIM, Flagedorn FI, Flensley VR, Flensley WJ, Starmer GA. (1975). The effect of caffeine on human performance, alone and in combination with ethanol. Psychopharmacologia. 45(2) 177-81. Franks P, Flarp J, Bell B. (1989). Randomized, controlled trial of clonidine for smoking cessation in a primary care setting. JAMA. 262(21) 3011-13. 

Gourlay S, Forbes A, Marriner T, Kutin J, McNeil J. (1994). A placebo-controlled study of three clonidine doses for smoking cessation. Clin Pharmacol Ther. 55(1) 64-69. 

Hilleman DE, Mohiuddin SM, Delcore MG, Lucas BD Jr. (1993). Randomized, controlled trial of transdermal clonidine for smoking cessation. Ann Pharmacother. 27(9) 1025-28. 

Nicotine dependence may respond to replacement therapy with either nicotine gum or transdermal patches, and detoxification from nicotine dependence has been described using clonidine. Bupropion, an antidepressant, also shows efficacy for smoking cessation. The nicotinic receptor blocker mecamylamine, which has good central nervous system access, has been used with limited efficacy. Overall, success rates for smoking abstinence at 1 year are about 20%, with even less success for depressed smokers. 

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. 

Gourlay SG, Stead LE, Benowitz NL. Clonidine for smoking cessation. Cochrane Database Syst Rev 2000 2 CD000058. 

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