Nortriptyline for quitting smoking
Although the U.S. Food and Drug Administration (FDA) has not approved nortriptyline for use in smoking cessation, the Tobacco Use and Dependence Clinical Practice Guideline Panel of the U.S. Public Health Service recommends it as a second-choice medicine for this use.1
How It Works
Exactly how nortriptyline works to help people quit smoking is not known. Doctors normally use nortriptyline to treat depression. But its action in helping people quit smoking is different from its antidepressant action. You do not have to have depression for nortriptyline to help you stop smoking.
Why It Is Used
Doctors prescribe nortriptyline to help people quit smoking if they have not been able to quit by using first-choice medicines (nicotine replacement therapy, varenicline, and bupropion hydrochloride). It is not a first-choice medicine, because it is more likely than these other medicines to cause side effects.
Nortriptyline should not be used during pregnancy unless the woman has not been able to quit smoking without medicine, the first-choice medicines have not been successful, and the benefits outweigh the risk for harm to the fetus.2
How Well It Works
Nortriptyline doubles your chances of quitting smoking. It is just as effective as other medicines to help people quit smoking.3
Using nortriptyline and nicotine replacement therapy at the same time may work better for some people than using nicotine replacement therapy alone.
Side effects occur in 64% to 78% of people who use nortriptyline. The most common are dry mouth and sleepiness.1
Other common side effects include:1
An overdose of nortriptyline can result in death.
FDA Advisory. The U.S. Food and Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. The FDA does not recommend that people stop using these medicines. Instead, a person taking antidepressants should be watched for warning signs of suicide. This is especially important at the beginning of treatment or when the doses are changed.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
Start taking nortriptyline 10 to 28 days before your quit date, and continue the medicine for 12 weeks after quitting smoking.
eMedicineHealth Medical Reference from Healthwise
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