Salín-Pascual RJ

Language: English
References: 10
Page: 16-20
PDF size: 84.08 Kb.

ABSTRACT

It has been reported that there is a link between major depression and nicotine dependence. Also, it has been shown that acute administration from one to four continuous days of transdermal nicotine improved depression in non-smoking major depressed patients. The goals of this study were to observe the antidepressant effect of transdermal nicotine in placebo non-responders non-smoking major depressed patients, after one week of daily nicotine administration, and to see if the antidepressant response to nicotine could predict the clinical outcome after fluoxetine or desimipramine administration.
Forty-two non-smoking major depressed patients were studied. After a complete explanation about the protocol, signed consents were obtained from all the subjects. Patients received placebo during two weeks. Placebo responders were removed from the study. Placebo non-responders patients received one-week transdermal nicotine patches (17.5 mg/24 hr) and placebo capsules for one week. Subsequently the patients were randomly assigned to desimipramine (150 mg/day) or fluoxetine (20 mg/day). Weekly visits were evaluated using both clinical scales, during six followup visits.
Twenty-three patients ended the study. Eleven showed an improvement in their depressed moody, after one week with nicotine patches (47.8 %). After this first week with antidepressant administration, nine patients with desimipramine and three with fluoxetine showed improvement (Fisher exact test: p‹0.05). Wilcoxon Matched-Pairs Signed Rank-Test comparing baseline with each visit evaluation showed statistical differences from the first week after nicotine administration in the desimipramine group (p‹0.01). Fluoxetine group showed clinical improvement two weeks after nicotine patches use ended.
A synergistic effect of both nicotine and desimipramine was observed with a high predictive value for this antidepressant. This may be related to the enhancement in the availability in catecholamines produced both by desimipramine and nicotine.

REFERENCES

1. BORRELI B, NIAURA R, KEUTHEN N, GOLDSTEIN MG, DEPUE JD, MURPHY C, ABRAMS DB: Development of major depression disorder during smoking-cessation treatment. J Clin Psychiatry, 57:534-538, 1996.

2. BRESLAU N, KILBEY M, ANDRESKI P: Nicotine dependence, major depression, and anxiety in young adults. Arch Gen Psychiatry, 48:1069-1074, 1991.

3. GLASSMAN AH, HELTZER JE, COVEY LS, COTTLER LB, STETNER F, TIPP JE, JOHNSON J: Smoking, smoking- cessation and major depression. JAMA, 264:1546-1549, 1990.

4. GWIRSTMAN HE, SZUBA MP, TOREN L, FEIST M: The antidepressant response to tricyclics in major depressive is accelerated with adjunctive use of metylphenidate. Psychopharmacol Bull, 30:157-164, 1994.

5. IMPERATO A, MULAS A, DI CHIARA G: Nicotine preferentially stimulates dopamine release in the limbic system of freely moving rats. Eur J Pharmacol, 132:337-338, 1986.

6. MESSIHA FS: Fluoxetine: a spectrum of clinical applications and postulates of underlying mechanisms. Neurosci Biobehav Rev, 17:385-396, 1993.

7. SALIN-PASCUAL RJ, DE LA FUENTE JR, GALICIAPOLO L, DRUCKER-COLIN R: Effects of transdermal nicotine on mood and sleep in non-smoking major depressed patients. Psychopharmacol, 121:476-479, 1995.

8. SALIN-PASCUAL RJ, ROSAS M, JIMENEZ-GENCHI A, RIVERA-MEZA BL, DELGADO-PARRA V: Antidepressant effect of transdermal nicotine patches in non-smoking patients with major depression. J Clin Psychiatry, 57:387-389, 1996.

9. SPITZER RL, WILLIAMS JBW, GOBBON M: Structured Clinical Interview for DSM-III-R. Biometrics Research Department. New York State Psychiatric Institute. New York, 1987.

10. YU ZJ, WECKER L: Chronic nicotine administration differentially affects neurotransmitter release from rat striatal slices. J Neurochem, 63:186-194, 1994.