New evidence boosts the conclusion that some antidepressants can double a smoker’s chance of quitting

Although nicotine medications are known to help people quit smoking, not everyone is helped by them or wants to use them. One possible alternative is to use antidepressants. The rationale for this is that some people may smoke to combat depression and that stopping smoking could trigger depressive symptoms in some smokers.

A Cochrane review first published in 1997 (and last updated in 2004) showed that the antidepressants bupropion and nortriptyline increase a person’s chances of giving up smoking, but selective serotonin reuptake inhibitors such as fluoxetine (Prozac) do not. An updated version of the review published in Jan 2007 now adds 17 more trials to the dataset, and now shows that bupropion and nortriptyline double a person’s chance of quitting – again SSRIs have no effect.

“Since bupropion and nortriptyline appear to work as well in non-depressed as depressed persons, this suggests they help smokers quit in some way other than as antidepressants,” says John Hughes, a Professor in the Department of Psychiatry at the University of Vermont, Burlington, USA.