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Commentary |

Psychiatry and Cigarettes

Alexander H. Glassman, MD
Arch Gen Psychiatry. 1998;55(8):692-693. doi:10.1001/archpsyc.55.8.692.
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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.

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