We appreciate the letter by Gambassi and Bernabei regarding our recent trial on nortriptyline for smoking cessation. It is clear that there is a wide gap between our clinical understanding of antidepressants for smoking cessation and the basic science data on the mechanism of action, especially since most trials of the antidepressants for smoking cessation, including our own, excluded subjects with overt depression. We agree that more targeted drug therapy will be necessary to increase cessation rates. The rationale for testing serotonin reuptake inhibitors is interesting and led to a large trial using fluoxetine for smoking cessation that was completed a number of years ago. Portions of the data have been published1 and a full report is currently in preparation (Raymond Niaura, PhD, written communication, January 1999). Results of this study will be interesting and may clarify the role of these agents in smoking cessation.
Prochazka AV, Weaver MJ. Antidepressants and Smoking Cessation. Arch Intern Med. 1999;159(11):1254. doi: