ARS | Publication request: Combined effects of venlafaxine, nicotine replacement, and brief counseling on smoking cessation

Submitted to: American Psychological Association (APA) Experimental and Clinical Pharmacology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: September 20, 2005
Publication Date: November 20, 2005
Citation: Cinciripini, P.M., Tsoh, J.Y., Wetter, D.W., Lam, C., De Moor, C., Cinciripini, L., Baile, W., Anderson, C.B., Minna, J.D. 2005. Combined effects of venlafaxine, nicotine replacement, and brief counseling on smoking cessation. American Psychological Association (APA) Experimental and Clinical Pharmacology. 13(4):282-292.

Interpretive Summary: This study looked at the long-term effect of a smoking cessation program that included the nicotine patch, an antidepressant, and behavioral counseling. The addition of the antidepressant did not produce an increase in smoking cessation, as was hypothesized. However, cessation benefits were greater for lighter smokers at baseline (<20 cigarettes per day) than for heavy smokers (> 25 per day).

Technical Abstract: In this study, 147 smokers were randomly assigned to receive either venlafaxine or placebo in conjunction with behavioral counseling (9 weekly sessions) and transdermal nicotine replacement therapy (22 mg/day). Patients began medication 2 weeks before quitting and continued for 18 weeks after quitting, with the daily dose titrated from 150 to 225 mg. in response to symptoms of negative affect and relapse. The results showed no main effect of treatment on abstinence. Post hoc analysis revealed that both at the end of treatment and at the 1-year follow-up smokers consuming less than a pack of cigarettes a day benefited from the addition of venlafaxine to the treatment regimen. Venlafaxine also reduced negative affect for all smokers for up to 6 weeks postcessation. The findings suggest that venlafaxine could have some role to play in the treatment of lighter smokers, in addition to the expected benefits of nicotine replacement therapy and behavioral counseling.