To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: Psychiatrists Use Antidepressants To Treat Smoking Addiction URL: http://www.pslgroup.com/dg/6E5EE.htm Doctor's Guide April 23, 1998
GAINESVILLE, FL. -- April 23, 1998 -- University of Florida psychiatrists are wielding new weapons in the war against nicotine addiction -- antidepressants. Part of a three-pronged approach that may include nicotine replacement therapy and counselling, the idea is to help smokers kick the habit by tackling addiction at its root: long-lasting changes in brain chemistry that train the brain to expect new levels of pleasure it eventually considers normal. This chemical conditioning occurs gradually, but the changes persist for months after someone stops smoking, setting the stage for relapse, reports UF substance abuse expert Dr. Mark Gold in an article on tobacco smoking and nicotine dependence in the current edition of the Journal of Addictive Diseases. As a result, many people who try to quit report feeling irritable, moody and even depressed, Gold said, professor of psychiatry, neuroscience, community health and family medicine at the UF Brain Institute and UF's College of Medicine. Smoking tobacco, like smoking heroin or cocaine, is profoundly addictive and nicotine dependence is particularly resistant to treatment, he said. Treatment programs for alcoholism and cocaine addiction are effective at least half the time. In contrast, although 80 percent of smokers want to stop, only 20 to 30 percent of those who do are smoke-free a year later. Less than five percent quit successfully with no intervention. "This is a very, very tenacious addiction," said UF psychiatrist Dr. Douglas Eaton, an addiction medicine specialist. "This is as hard an addiction to crack as heroin or cocaine -- right up there with the biggies." Up to now, many physicians have relied solely on the nicotine patch, which helps smokers cope with acute withdrawal symptoms. "Social prohibitions, the stigma and health information that smoking is bad for you works for some people," Gold said. "Who is left? People with a pathological attachment to smoking, who are getting antidepressant effects from smoking. They love smoking -- it's a source of pleasure. "The idea that you can treat all smokers with a nicotine patch or gum is not realistic. It's like saying you've discovered the cure for all alcoholism is alcohol. You wouldn't propose to most alcoholics who were drinking vodka that they should switch to beer. So the idea behind nicotine replacement and detoxification may be somewhat flawed." Smoking cigarettes is tied to more than 400,000 deaths in the United States each year from cancer, stroke and cardiovascular disease, according to the American Lung Association. UF physicians, practising in the newly formed Smoking Cessation Clinic within the Psychiatric Specialty Clinics at Shands hospital at UF, tackle the problem on both fronts -- using nicotine replacement therapy to treat acute withdrawal symptoms and antidepressants to combat the longer-lasting brain changes. Smoking releases a cascade of brain chemicals associated with survival-enhancing behaviours such as eating and sex. UF physicians have studied the effects of two new medications for smoking: buproprion and naltrexone. Both act on the area of the brain that rewards survival-enhancing behaviours. UF physicians also offer patients strategies for attaining and maintaining abstinence from tobacco. "Of course, smoking cigarettes is not survival enhancing, but the brain doesn't know that," Eaton said. "We in the addiction field have known that smoking is a drug addiction as serious or devastating in the long run as heroin or cocaine. "It is perhaps even more malicious because the negative effects are not as quickly apparent, so it's easier for everyone involved to be in denial about the seriousness of the problem." --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.