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Double-Blind Placebo-Controlled Trial of Fluoxetine in Smoking Cessation Treatment Including Nicotine Patch and Cognitive-Behavioral Group Therapy

Authors

  • Karen K. Saules Ph.D.,

    Corresponding author
    1. The Substance Abuse Research Division, Department of Psychiatry and Behavioral Neurosciences, Wayne State University, School of Medicine, Detroit, Mich.
    2. Dr. Saules is now at Eastern Michigan University, Ypsilanti, Mich.
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  • Leslie M. Schuh Ph.D.,

    1. The Substance Abuse Research Division, Department of Psychiatry and Behavioral Neurosciences, Wayne State University, School of Medicine, Detroit, Mich.
    2. Dr. Schuh is now at Eli Lilly and Company, Indianapolis, Ind.
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  • Cynthia L. Arfken Ph.D.,

    1. The Substance Abuse Research Division, Department of Psychiatry and Behavioral Neurosciences, Wayne State University, School of Medicine, Detroit, Mich.
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  • Karen Reed B.A.,

    1. The Substance Abuse Research Division, Department of Psychiatry and Behavioral Neurosciences, Wayne State University, School of Medicine, Detroit, Mich.
    2. Ms. Reed is now at Michigan State University, Lansing, Mich.
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  • M. Marlyne Kilbey Ph.D.,

    1. The Substance Abuse Research Division, Department of Psychiatry and Behavioral Neurosciences, Wayne State University, School of Medicine, Detroit, Mich.
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  • Charles R. Schuster Ph.D.

    1. The Substance Abuse Research Division, Department of Psychiatry and Behavioral Neurosciences, Wayne State University, School of Medicine, Detroit, Mich.
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Address correspondence to Dr. Saules, Eastern Michigan University, Psychology Clinic, 611 W. Cross Street, Ypsilanti, MI 48197. E-mail: ksaules@emich.edu.

Abstract

Smoking cessation attempts are often complicated by dysphoria/depression, weight gain, craving, and other nicotine withdrawal symptoms. Fluoxetine's antidepressant and anorectant properties, along with its capacity to attenuate compulsive behavior, suggest that this medication might facilitate smoking cessation treatment. We examined the effect of fluoxetine on smoking cessation in the context of a program that included group cognitive-behavioral therapy (six weeks) and transdermal nicotine patch (ten weeks). In a double-blind randomized trial of fluoxetine for smoking cessation, 150 daily smokers were assigned to placebo (n = 48), 20 mg (n = 51), or 40 mg fluoxetine (n = 51). Fluoxetine did not significantly improve smoking cessation rates, either for those with or without major depressive disorder (MDD) histories or elevated current depression. Our results suggest that fluoxetine may moderate withdrawal symptoms, even if that was not manifested in improved smoking cessation rates. Our results, however, clearly favor the use of fluoxetine if weight gain is a major clinical obstacle to smoking cessation.

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