Non-nicotine pharmacotherapies for nicotine dependence

Essent Psychopharmacol. 2005;6(3):158-72.


The smoking rate for patients with schizophrenia reaches as high as 90% in clinical samples, 70% for patients with bipolar disorder, and 40% to 50% for patients with major depression and anxiety disorders. Because it is a significant health hazard, smoking should be aggressively discouraged, and, in this group of patients, a combination of behavioral therapy and pharmacotherapy currently offers the best option. Nicotine provides a number of benefits, including anxiety relief, increased alertness, and improved cognitive functioning. It alters a wide range of central nervous system neurotransmitters. Unfortunately, nicotine readily establishes physiological dependence. In cessation efforts, transdermal nicotine patches and nicotine gum are helpful adjuncts. The primary FDA approved non-nicotine pharmacotherapy agent is bupropion (Zyban). Studies summarizing the effectiveness (or lack thereof) of other (off-label) agents, such as tricyclic antidepressants, MAO-Inhibitors, SSRIs, and clonidine, are cited.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Antidepressive Agents / therapeutic use
  • Bupropion / therapeutic use
  • Clinical Trials as Topic / statistics & numerical data
  • Drug Therapy
  • Humans
  • Nicotine / therapeutic use
  • Tobacco Use Disorder / drug therapy*
  • Tobacco Use Disorder / epidemiology
  • Tobacco Use Disorder / psychology*


  • Antidepressive Agents
  • Bupropion
  • Nicotine