IN THIS issue of the ARCHIVES, Hall and her colleagues1 present data indicating that nortriptyline hydrochloride, a tricyclic antidepressant, increases smoking abstinence rates. Using antidepressant drugs as aids to smoking cessation stems from the 1988 observation that cigarette smoking is associated with a history of major depression and that a history of depression predicts smoking cessation failure.2 These observations have been replicated on numerous occasions and it is now clear that nicotine withdrawal can provoke depression in smokers with a history of depression.3 These observations led a number of individual investigators as well as pharmaceutical manufacturers to hypothesize that antidepressant compounds might aid smoking cessation. However, the trials that tested this hypothesis produced unanticipated results.
Glassman AH. Psychiatry and Cigarettes. Arch Gen Psychiatry. 1998;55(8):692-693. doi:10.1001/archpsyc.55.8.692