127. Treatment Recommendations: Medications (Continued)
Treating Tobacco Use and Dependence: 2008 Update
Text version of slide presentation.
Clinical guidelines for prescribing medication for treating tobacco use and dependence (continued)
When should second-line agents be used for treating tobacco dependence? | Consider prescribing second-line agents (clonidine and nortriptyline) for patients unable to use first-line medications because of contraindications or for patients for whom the group of first-line medications has not been helpful. Assess patients for the specific contraindications, precautions, other concerns, and side effects of the second-line agents. Please refer to FDA package inserts for this information and to the individual drug tables in this document. |
Which medications should be considered with patients particularly concerned about weight gain? | Data show that bupropion SR and nicotine replacement therapies, in particular 4 mg nicotine gum and 4 mg nicotine lozenge, delay, but do not prevent, weight gain. |
Are there medications that should be especially considered in patients with a past history of depression? | Bupropion SR and nortriptyline appear to be effective with this population but nicotine replacement medications also appear to help individuals with a past history of depression. |