Current and emerging pharmacotherapies
for treating tobacco dependence

by
Schnoll RA, Lerman C.
Department of Psychiatry,
Transdisciplinary Tobacco Use Research Center,
University of Pennsylvania,
3535 Market Street, 4th Floor,
Philadelphia, PA 19104, USA.
Schnoll@mail.med.upenn.edu
Expert Opin Emerg Drugs. 2006 Sep;11(3):429-44.


ABSTRACT

Tobacco dependence remains the leading cause of death and disease in the US and a major cause of mortality around the world, yet 1 out of 5 American adults smoke and 1.3 billion adults smoke worldwide. Nicotine replacement therapies (NRTs), bupropion and varenicline, are approved by the US FDA as first-line treatments for nicotine dependence. Clonidine and nortriptyline are recommended as second-line treatments by the Agency for Healthcare Research and Quality. Although recent data suggest that varenicline is superior to bupropion for treating nicotine dependence, a majority of smokers fail to maintain long-term abstinence from smoking using FDA-approved pharmacotherapies. Thus, continued investigation of novel medications for nicotine dependence remains a critical priority. Guided by research on multiple neurobiological mechanisms of nicotine dependence, several novel medications that mimic and/or attenuate nicotine's rewarding effects, or reduce nicotine withdrawal, are under investigation. Although existing data are limited or conflicting, there is some evidence for the efficacy of selegiline, fluoxetine, naltrexone and mecamylamine in certain subgroups of smokers. New research directions, such as fast-acting NRTs, the tailored use of NRTs for subtypes of smokers, and pharmacogenetics, hold promise for new treatment approaches and, ultimately, for reducing rates of tobacco use in the US and worldwide.

EMSAM
Tobacco
Structure
Metabolites
Interactions
Parkinson's disease
Desmethylselegiline
Selegiline and the DAT
Selegiline and the brain
Selegiline and nitric oxide
Selegiline and life-expectancy
Selegiline as an immunostimulant
Selegiline for cocaine-dependence


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