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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
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?
Posted by Judy on October 30, 1999, at 19:06:00
In reply to Anti-Depressants and The Patch..., posted by Racer on October 30, 1999, at 17:57:38
>>Patch package says that they're contraindicated for use with anti-depressants? Any light to be shed here?
Racer,
Good question! It sent me searching the web for the SmithKline Beecham site (manufacturers of NicoDerm) to see what the contraindications were because I was prescribed the Patch many years ago by my PCP, who knew I was taking AD's but never said anything at the time about it. Her only warning was "DO *NOT* SMOKE AND WEAR THE PATCH AT THE SAME TIME!! IF YOU HAVE TO BREAK DOWN AND HAVE A CIGARETTE, TAKE THE PATCH OFF FIRST!!!"
Interestingly, the SmithKline Beecham site had *nothing* to say about contraindications/adverse effects, so I went to the next website on the list, Drake University College of Pharmacy (http://pharmacy.drake.edu/faculty/pharmaceuticalinformatics/Students/kirsten/!NICODER.MCQ/!nicoder.htm) and found the following:
Contraindications:
Use of NicoDerm CQ systems is contraindicated in patients with hypersensitivity or allergy to nicotine. [Judy Annotation: Wouldn't this have contraindicated our smoking a long time ago?!?]
Caution should be used in patients who have experienced any of the following:
a recent heart attack (myocardial infarction)
irregular heart beat (arrhythmia)
severe or worsening heart pain (angina pectoris)
allergies to drugs
rashes from adhesive tape or bandages
skin diseases
very high blood pressure
stomach ulcers
overactive thyroid
diabetes requiring insulin
kidney or liver diseaseDrug Interactions:
Smoking cessation, with or without NicoDerm CQ therapy, results in physiological changes which may
alter the pharmacokinetics of some concomitant medications; therefore, may require dosage
adjustment.Adverse Effects:
The most common adverse effects associated with topical nicotine is a short-lived erythema (abnormal
flushing of the skin), pruritus (itching), and/or burning at the application site. Other common adverse
effects include:
insomnia
headache
diarrhea
dyspepsia (indigestion)
nervousnessMy comments again: Doesn't look like a problem to me. I suffered no ill effects when I used the patch and took (?) Nardil, I think - but it's been a long time. Didn't help me quit smoking either! I was actually able to quit by using Nicorette gum, I suspect because I needed the physical gratification of opening each incredibly well-sealed piece of gum when I had the urge to smoke, same as fumbling for my cigs and lighting up I guess.
There's a wealth of information to be had on the web about the Patch - I used Northern Light as a search engine and typed in simply "Nicotine Patch"
Good luck & Merry Christmas!
Judy
Posted by saint james on October 30, 1999, at 22:45:50
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?
>
James here....I did the patch a year ago and had no problems. To me if you smoke and take AD's the patch is no different. I smoke a pack a day and the lowest level patch was plenty ! I tried the gum...hated it ! I liked the patch because it's the first cig
in the morning that I have to have. You might consider upping you AD dose a little.j
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.
Posted by Judy on October 31, 1999, at 10:26:46
In reply to Re: Anti-Depressants and The Patch..., posted by JohnL on October 31, 1999, at 1:53:47
>The theory is that smoking stimulates dopamine
While I was doing my 'homework' on the patch last night, I read at several different websites that the nicotine patch is being tested (quite successfully it seems) as a potential aid in reducing the symptoms of Parkinson's and Alzheimer's Diseases. Also read that smokers are less likely to suffer early onset of Parkinson's.
I stupidly mentioned to my college-age daughter (who is vehemently anti-smoking) that maybe this was one bright side to smoking. Her response was "Swell, Mom! I'm sure you'll enjoy all your mental faculties when you're slowly dying of lung cancer!" And a child shall lead them...?
Judy
Posted by Racer on October 31, 1999, at 11:33:26
In reply to Further to JohnL's post, posted by Judy on October 31, 1999, at 10:26:46
We'll have to introduce her to my boss!
Thanks for the info. I'll pass it on, and maybe I'll get my Christmas gift this year: a new, non-smoking me!
Thanks also for the info JohnL gave regarding dopamine levels and nicotine. Since Effexor is supposed to effect dopamine, I guess I'll have to do some more research.
Judy, you wanna be quit buddies? Email and/or post as we struggle with quitting?
Posted by danwebs on November 2, 1999, at 18:18:26
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?See The Ontario Medical Association report
"Rethinking Stop-Smoking Medications:
myths and facts
http://www.oma.org.phealth/stopsmoke.htm#use
Posted by Judy on November 2, 1999, at 19:52:37
In reply to Judy's Daughter..., posted by Racer on October 31, 1999, at 11:33:26
>
> Judy, you wanna be quit buddies? Email and/or post as we struggle with quitting?
Racer ~ I responded to your post yesterday, but apparently it never made it through cyberspace! I have to get psyched first - what's your planned Kick-Off Day? Think anyone else wants to be miserable with us? ~ Judy
This is the end of the thread.
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