Pharmacological Treatment for Nicotine Dependence

Joe, Keun Ho; Kim, Dai Jin

Abstract

It was not above two or three decades from the changes began that regarding nicotine dependence as a kind of addictive disorder and a therapeutic target. Despite the short period of history, lots of medications were developed and showing significant clinical outcomes. In this review, we introduce the both of medications available at this time and in the status of developing for nicotine dependence. The clinical efficacies, practical ways of prescription, and common adverse events of the medications currently available are described through the survey of literatures. The novel medications in the process of developing are arranged by the proposed mechanism of action and summarized the phases of clinical trials at present. Among the diverse pharmacological tools now available, nicotine replacement and bupropion could be the first-line recommendation drugs and nortriptyline and clonidine could be the second-line recommendation drugs. Other medications like several antidepressants (e.g., moclobemide), buspirone, and naltrexone may be helpful in some specific population. Most of medications currently available have uncertainties in the aspects of their mechanisms of action except nicotine replacement materials; however, medications in developing have clearer neurobiological basis in their applications. Therefore, we can expect higher treatment outcomes by new products. Additionally, introduction of nicotine vaccines for high-risk group is drawing near. It could be possible for the individualizing for strategies of smoking cessation according to the patients' specific situation in a future.