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Re: Anti-Depressants and The Patch...

Posted by JohnL on October 31, 1999, at 1:53:47

In reply to Anti-Depressants and The Patch..., posted by Racer on October 30, 1999, at 17:57:38

> OK, experts, what do you know about the warnings about Nicotine Patches and anti-depressants?
> My boss is going to give me a package or ten of nicotine patches for Christmas (yippee!), but she said that the Patch package says that they're contraindicated for use with anti-depressants? Any light to be shed here?

I don't have an expert answer. Just my $.02 is all I got here. I haven't seen the package so I don't know. But it seems silly because I have read in many places that Zyban (the AD Wellbutrin) AND patch or gum has a better quit rate than either alone. And I saw a host of clinical studies with both. Nortriptyline has also been clinically tested for smoking cessation and can be used with the patch for an increased success rate.

I don't think nicotine has anything to do with serotonin. I wish it did because I would be cured! I would smoke more! Ha! (joking) If anything at all, it has to do with dopamine and/or NE, which is why Wellbutrin is known for use in smoking cessation. The theory is that smoking stimulates dopamine. There's a view that many depressives are smokers as they subconciously attempt self-medication with nicotine. That's one of the reasons why a smoker lights up when they feel bad. Since the smoker's brain chemistry is accustomed to that, stopping smoking causes a rapid drop-off in dopamine. Thus the depression and irritibility of someone trying to quit. Wellbutrin, with its supposed dopamine action, attempts to hold brain chemistry steady.

I am just guessing that the warning on the label probably says something about checking with your doctor before using the patch with any prescription medicines including antidepressants. One of those standard industry warnings to guard against lawsuit. Maybe they're concerned someone on antidepressants is in a group of people already mentally vulnerable for suicide or something. They cover their butts by saying to check with your doctor first. Just a guess.




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