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Addiction Information > Drug Abuse Treatment Guidelines - The management of withdrawal syndromes - Part 8

THE MANAGEMENT OF WITHDRAWAL SYNDROMES

DETOXIFICATION FROM NICOTINE

Nicotine replacement therapies such as the nicotine patch and nicotine gum may aid smokers in withdrawal from nicotine. Such therapies have been shown to boost the rates of smoking cessation by a factor of 1.4 to 2.6 (Fiore at al, 1996) in comparison with placebo treatments, but 70 to 80 per cent of smokers who use these therapies still start to smoke again.A maximum of two weeks should be prescribed at any one time, and replacement prescriptions only given to those who attend for a follow-up appointment.

Buproprion is a non-nicotine preparation recently marketed as an aid to help stop smoking. It is available on the NHS as a prescription-only medicine. When used in a specialist setting and in conjunction with regular counselling, it is at least twice as effective as placebo in helping patients to stop smoking (Drugs and Therapuetics Bulletin, 2000). Buproprion commonly causes dry mouth and insomnia and is contraindicated in patients with epilepsy as it can cause seizures. It has the potential to interact with and prolong the action of a range of other medications including certain antidepressants (e.g. desipramine and paroxetine), type 1c antiarrythmics

  • Nicotine replacement therapies such as the nicotine patch and nicotine gum may aid smokers in withdrawal from nicotine. A maximum of two weeks should be prescribed at any one time.
  • When used in a specialist setting and in conjunction with regular counselling, buproprion is at least twice as effective as placebo in helping patients to stop smoking.

(e.g. propafenone and flecanide) and antipsychotics (e.g. risperidone). It may also interact with medicines known to affect the CYP2B6 system.

There is some indication that dual therapy with nicotine patches and buproprion may enhance cessation rates further, although the trend did not reach statistical significance in the study that examined this (Jorenby DE et al., 1999).

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Triage Healthcare provide treatment at the following addictions clinics in South Africa:

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Cape Town
Durban.
Storms River


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