Tobacco use is one of the greatest public health burdens in the world. In the developing world, the problem is especially severe, as health education and disease prevention programs are underfunded or simply nonexistent. Tobacco use in the form of cigarettes is a leading cause of preventable death. Lung cancer, heart disease, and hardened arteries are all effects of long-term smoking. Unfortunately, one of the major chemical components of tobacco—nicotine—is also a highly addictive psychotropic substance.
Dependence on nicotine means that an individual requires the chemical at regular intervals in order feel “normal.” Withdrawal from nicotine induces brain states that mirror major depression in surprising ways. The similarities between nicotine withdrawal and depression have sparked research on the question of whether certain antidepressant medications might aid those wishing to quit tobacco.
The tricyclic antidepressant Norpramin (desipramine) is not a new drug. This class of antidepressants has largely been overtaken by the selective serotonin reuptake inhibitors for the treatment of depression. However, researchers continue to investigate possible alternate uses of these older drugs. One of these possible uses is in the treatment of people addicted to nicotine during the withdrawal and recovery process. A study with rats attempted to gauge whether acute or chronic doses of Norpramin might ease withdrawal symptoms, namely depression and boredom. Researchers were also interested in whether Norpramin might reduce self-administration of nicotine, demonstrating a relaxation of its chemically addictive properties.
Results were mixed. On the one hand, acute administration had no effect on either withdrawal symptoms or self-administration of nicotine. On the other hand, chronic administration—a longer series of daily doses—showed encouraging signs. Rats exhibited fewer symptoms of withdrawal as well as lower rates of self-administration. Curiously, the rats also showed a decreased interest in food, highlighting the intricate link between the brain’s reward centers.
Despite the encouraging results of chronic Norpramin exposure, more work is needed before human trials can begin. Antidepressant medications all incur a risk of side effects. These risks must be weighed against the benefits of smoking cessation. Likewise, certain patients may respond more or less well to pharmaceutical interventions. Determining the right formulation and dose schedules is an important point as well. Because Norpramin’s purpose for tobacco users is not in the treatment of depression per se, a lower dose is almost certainly appropriate. Future research will shed light on all of these questions and issues.
Paterson, N. E., Semenova, S., Markou, A. (2008). The effects of chronic versus acute desipramine on nicotine withdrawal and nicotine self-administration in the rat. Psychopharmacology, 198(3), 351-362.
© Copyright 2011 by James Pendleton. All Rights Reserved. Permission to publish granted to GoodTherapy.org.
The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.