Failure to improve cigarette smoking abstinence with transdermal selegiline + cognitive behavior therapy

Authors: Killen, Joel D.; Fortmann, Stephen P.; Murphy, Greer M.; Hayward, Chris; Fong, Dalea; Lowenthal, Kimberly; Bryson, Susan W.; Killen, Diana T.; Schatzberg, Alan F.

Source: Addiction, Volume 105, Number 9, September 2010 , pp. 1660-1668(9)

Publisher: Wiley-Blackwell

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Abstract:

Aims

To examine the effectiveness of transdermal selegiline for producing cigarette smoking abstinence. Design

Adult smokers were randomly assigned to receive selegiline transdermal system (STS) or placebo given for 8 weeks. All participants received cognitive behavior therapy (CBT). Follow-ups were conducted at 25 and 52 weeks. Setting

Community smoking cessation clinic. Participants

243 adult smokers (≥18 years of age; ≥10 cigarettes/day). Measures

Expired-air carbon monoxide confirmed 7-day point prevalence abstinence. Findings

STS was not superior to placebo. More women than men were abstinent at 52 week follow-up (28% vs 16%, P < 0.05). Behavioral activation (BAS) moderated treatment response (P = 0.01). The survival rate through week 52 for those with high `drive' scores on the BAS was 47% if assigned to selegiline and 34% if assigned to placebo. The survival rate for those with low `drive scores' on the BAS was 35% if assigned to selegiline compared to 53% if assigned to placebo. Conclusion

Transdermal selegiline does not appear generally effective in aiding smoking cessation though there may be a selective effect in those smokers with low `behavioral activation'.

Keywords: Nicotine dependence; selegiline; smoking cessation

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1360-0443.2010.03020.x

Publication date: 2010-09-01