Comparing the effectiveness of Nortriptyline and Nicotine gum with counseling for Smoking Cessation in Nicotine Dependence Smokers

Abstract

Introduction The treatment for nicotine dependence is limited in practice because of a controlled budget and adverse drug reactions.This research aimed to evaluate the effectiveness of nortriptyline(the treatment group) and nicotine gum(the comparision group). Methods This clinical control trial was designed. Both groups received counseling. Researchers collected, the rate of smoking cessation, number of cigarettes smoked per day, levels of carbon monoxide (CO), adherence and adverse drug reactions every month for four months. Results The cessation rates with nortriptyline were 16.8%, 39.4%, 73.7% and 75.0% and with nicotine gum were 18.1%, 34.0%, 67.4% and 70.5% at month 1, 2, 3 and 4, respectively. The decremental proportion of cigarettes smoked per day at month 4 compare with the quiting date were 13.1+5.7 cigarettes/day with nortriptyline and 12.8+6.5 cigarettes/day with nicotine gum, but there was not different between two groups.The incremental proportion of exhaled carbon monoxide (CO) < 10 ppm were 17.4% with nortriptyline and 24.4% with nicotine gum (p<0.05). Adverse drug reactions with nortriptyline and nicotine gum were found 70.3% and 30.5%, respectively. The top three highest adverse drug reactions with nortriptyline were sleepy (56.4%), dry mouth (34.7%) and bitter test (8.9%). And with nicotine gum were flatulent (15.8%), stomach pain (8.4%) and tired jaw (6.3%). Adherence rate was not different between groups (59.2% with nortriptyline and 68.6% with nicotine gum). Conclusions Adverse drug reactions were found higher with nortriptyline than nicotine gum, nevertheless, there was not any serious adverse events within 3 months of the treatment.