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CENTURY
Yale University
School of Medicine
SAC-203
Connecticut
Mental Health Center
34 Park Street
New Haven, CT 06519

Phone:
203-974-7591

Fax:
203-974-7606

E-mail:
infocentury@yale.edu

CENTURY/TTURC Press Release

Novel Pharmacological Strategies Could Help Smokers Quit

New Haven -- Quitting smoking is not a one-size-fits-all proposition. What works for one smoker might not work for another. Researchers are finally beginning to figure out why, according to a study published in this month's Trends in Pharmacological Sciences .

“Different smokers respond to different medication treatments, because of different biological subtypes of nicotine dependence,” said lead author, Dr. Tony P. George, an assistant professor of psychiatry at the Yale University School of Medicine. “For example, nicotine replacement therapy doesn't seem to work as well for women as it does for men. Women may respond better to Buproprion or Naltrexone. In this article, we review all the relevant medications and weight the evidence for and against their use as a smoking cessation aids.”

The article provides information on the following medications;

• nicotine replacement therapies, including the patch, gum, lozenge, nasal spray and vapor inhaler,

• Buproprion Hydrochloride, also known as Zyban ® ,
• Clonidine(Catapres ®)
• Tricyclic antidepressants including Nortriptyline (Pamelor ®) and Doxepin (Sinequan ®)
• Mecamylamine (Inversine ® )
• Naltrexone (Trexan ® or ReVia ® )
• Buspirone (BuSpar ® )
• Selegiline (Eldepryl ® )

“Recent developments in our understanding of the neurobiology of nicotine dependence have identified several neurotransmitter systems which may contribute to the process of smoking maintenance and relapse …” Dr. George says in the article. “Several existing medications are being tested for treatment of nicotine dependence and several novel investigational agents are under development which might provide effective treatments for nicotine dependence in the ‘hard to treat' tobacco user.”

Dr. George, a psychiatrist and an investigator with the Transdisciplinary Tobacco Use Research Center (TTURC) at Yale, points out that many people who still smoke, about 23 percent of the population in the United States and about 1.1 billion people worldwide, may also have psychiatric or other drug-abuse disorders that make it harder for them to quit. People suffering from schizophrenia, major depression or alcoholism, for example, might be smoking as a form of self-medication, or have a specific biological vulnerability to tobacco addiction based on the nature of their illness, he said.

A review of the current literature on those disorders and the drugs listed above shows that there is increasing evidence that medications can be matched to anti-smoking strategies for those who still smoke, he said, adding that the information could prove particularly useful to psychiatrists and other physicians who help treat patients who smoke.

The article is co-authored by Dr. Stephanie O'Malley, the TTURC principal investigator and a leading expert on Naltrexone, an opioid antagonist that is used as therapy for alcoholism. Dr. O'Malley, who is currently investigating how naltrexone might help smokers quit, said the article reflects the core mission of the TTURC. “We have a heavy emphasis on translating basic biological mechanisms to treatment, with a focus on helping smokers who find it hard to quit.”

The citation for the article: Tony P. George and Stephanie S. O’Malley. Current pharmacological treatments
for nicotine dependence. TRENDS in Pharmacological Sciences Vol.25 No.1 January 2004.