 |
|
Transdermal Clonidine Reduced Some Withdrawal Symptoms but Did not Increase Smoking Cessation
Allan V. Prochazka, MD, MSc;
Thomas L. Petty, MD;
Louise Nett, RN, RRT;
G. Wayne Silvers;
David P. L. Sachs, MD;
Stephen I. Rennard, MD;
David M. Daughton, MS;
Richard H. Grimm, Jr;
Craig Heim, MD
Arch Intern Med. 1992;152(10):2065-2069.
Abstract
| |
Background.—
Clonidine may be useful in controlling tobacco withdrawal and in facilitating smoking cessation. This study was developed to test the efficacy of transdermal clonidine in promoting smoking cessation.
Methods.—
We conducted a five-center, double-blind, placebo-controlled, randomized controlled trial of transdermal clonidine in conjunction with a minimal behavioral intervention for smoking cessation. The intervention was based on the American Lung Association's Freedom From Smoking program. Self report of not smoking was validated with exhaled air carbon monoxide of less than 8 ppm and salivary cotinine of less than 20 ng/mL. Transdermal clonidine therapy began 1 week before the target quit date: 0.1 mg/24 h for the first 4 days increasing to 0.2 mg/24 h for the next 3 days, if the lower dose was tolerated. The highest tolerated dose was then continued for 6 weeks after target quit day. Withdrawal symptoms were measured daily for the first 7 days after target quit day.
Results.—
A total of 213 patients were enrolled (106 active drug and 107 placebo). During the study, 15.5% of patients had drug therapy discontinued due to adverse effects, 24.5% (26/106) taking active drug vs 8.4% (9/107) receiving placebo. There was a significant reduction in anxiety score from 3.0 to 2.4 (placebo vs active) and irritability score from 2.2 to 1.7 (placebo vs active) during the first week after cessation. There was no reduction in other withdrawal symptoms. The overall 12-week abstinence rate was 33.0% (35/106) in the active drug group vs 34.5% (37/107) in the placebo group (not significant).
Conclusion.—
This study demonstrated some reduction in early withdrawal symptoms with the use of a clonidine transdermal patch, but no increase in cessation rate, 6 weeks after medication had been discontinued.
(Arch Intern Med. 1992;152:2065-2069)
Author Affiliations
From the Ambulatory Care Section, Denver Veterans Affairs Medical Center (Dr Prochazka), and Presbyterian-St Luke's Center for Health Sciences Education (Dr Petty and Ms Nett and Mr Silvers), Denver, Colo; Palo Alto (Calif) Center for Pulmonary Disease Prevention (Dr Sachs); Pulmonary Section, Department of Medicine, University of Nebraska, Omaha (Dr Rennard and Mr Daughton); School of Public Health, University of Minnesota, Minneapolis (Dr Grimm); and Section of General Internal Medicine, Department of Medicine, Vanderbilt University, Nashville, Tenn (Dr Heim).
Footnotes
Accepted for publication April 7, 1992.
Reprints not available.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
A 36-Year-Old Woman Who Smokes Cigarettes
Rigotti
JAMA 2000;284:741-749.
FULL TEXT
New Developments in Smoking Cessation
Prochazka
Chest 2000;117:169S-175S.
ABSTRACT
| FULL TEXT
Clonidine Prophylaxis for Narcotic and Sedative Withdrawal Syndrome Following Laryngotracheal Reconstruction
Deutsch and Nadkarni
Arch Otolaryngol Head Neck Surg 1996;122:1234-1238.
ABSTRACT
An Analysis of the Effectiveness of Interventions Intended to Help People Stop Smoking
Law and Tang
Arch Intern Med 1995;155:1933-1941.
ABSTRACT
CLONIDINE PATCH FAILS TO INCREASE SMOKING CESSATION
JWatch General 1992;1992:3-3.
FULL TEXT
|
