| Summary: | Background
Current smoking cessation methods are primarily based on the theory that nicotine is the principal addicting compound overlooking the contribution of the monoamine oxidase inhibitors present in tobacco. Our study tests the hypothesis that the MAOI phenelzine can successfully mimic and replace the MAOI effects of tobacco's harmala alkaloids and aid in the reduction and cessation of tobacco use.
Methods
Current smokers were treated with the MAOI phenelzine. All patients were given information regarding the risk of interactions between MAOIs and other medications and certain tyramine-containing foods. Those who had previously been treated with SSRIs, pain medications or other potentially reactive medications were told to stop taking those medications for a wash-out period of 2 weeks prior to starting the MAOI. The patients were titrated up from an initial dose of approximately 1.875mg (one-eighth of a 15mg tablet) every 2 hours to a maximum of 15mg TID.
Results
Both of the patients described here had failed previous treatment with NRTs (nicotine gum, nicotine lozenges, and nicotine transdermal patches). Following treatment with phenelzine each demonstrated a significant improvement in scoring on the Fagerstrom Test for Nicotine Dependence (FTND) and the Quality of Life and Satisfaction Questionnaire-
Short form (Q-LES-Q-SF).
Conclusions
These preliminary findings, which have been
duplicated in approximately 35% subjects treated with phenelzine, suggest
a potent new treatment for tobacco addiction. We are currently
collecting more data on smokers receiving phenelzine to fortify our argument that
tobacco addiction is about more than nicotine dependence. Multiple components
in tobacco, their combustion products, and their metabolized by-products may
contribute to tobacco addiction. Phenelzine, a non-selective monoamine oxidase
inhibitor, appears be useful in the treatment of tobacco addiction, a scourge
which kills or cripples millions of people throughout the world as well as
drains financial resources from those chained to this highly addictive
compound.
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