The Pharmaceutical Journal
Vol 280 No 7502 p590
17 May 2008

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Combination of NRT and nortriptyline unlikely to be more effective than single therapies in smoking cessation

A combination of nortriptyline and nicotine replacement therapy (NRT) is unlikely to be more effective at helping people stop smoking than offering the therapies separately, according to the results of a study published online by the BMJ last month (27 April 2008).

Researchers discovered that 16 per cent of smokers taking the combination therapy were still not smoking six months after starting treatment compared with 12 per cent using NRT and a placebo. At 12 months, 11 per cent of smokers on dual therapy were still not smoking compared with 9 per cent in the placebo group. The differences were not statistically significant.

The researchers, led by Paul Aveyard from the division of primary care and public health, University of Birmingham, point out that those in the combined therapy group reported higher rates of dry mouth and constipation as well as feeling shaky and sweating compared with the placebo group. Taking nortriptyline did reduce feelings of depression and anxiety but both groups of smokers reported they still had the urge to smoke.

The researchers conclude: “Although nortriptyline alone has a place in smoking cessation clinics, the data show that the efficacy of combination treatment is slight and should not be used routinely.”

The results of the study were based on data from 901 people attending NHS smoking cessation services.