Abstract
Background: Varenicline acts as a partial agonist at central nicotinic receptors, which are important in mediating the reinforcement associated with tobacco smoking. During treatment, drug binding partially activates these receptors thereby reducing withdrawal symptoms and cravings. If the patient lapses and smokes, Varenicline reduces the access of nicotine to the receptors.
Objectives: To evaluates the efficacy and safety of Varenicline and Nortriptyline for smoking cessation in the outpatient.
Methods: Randomized, double-blind, controlled trial, 12weeks treatment and 16weeks follow-up trail was conducted during June,2015 to December,2015 at smoking cessation clinic Chulalongkorn Hospital. 60 subjects were randomized to receive Nortriptyline (10 to 50 mg/day)(n=30) or Varenicline (0.5 mg/day and titrated to 2 mg/day)(n=30). Smoking status was established by self-report and confirmed at clinic visits by end expiratory carbon monoxide. The primary end point was Point Abstinence Rate (PAR) at weeks 2, 4, 8 ,12 and 16 of treatment. The secondary end point were adverse events and recurrent smoking during treatment and post treatment
Results: The PARs at week 12and 16 were 30% with Nortriptyline versus 56.7% with Varenicline (p = 0.037). There are not statistical significant different in nicotine withdrawal symptomand the rate of recurrent smoking between patients recieved between Nortriptyline or Varenicline.
Conclusions: PARs tended to be greater than in Varenicline compared with Nortriptyline over 12 week of treatment and 16 week of follow up.
- Copyright ©the authors 2016