Posted by Tony P on January 3, 2012, at 22:53:21
In reply to Smokers: any med or supp. ever decreased smoking?, posted by uncouth on December 31, 2011, at 11:57:58
Can't say I've had a really dramatic spontaneous reduction in smoking as a result of medication, except maybe short-term in a few cases where the med. made me so sleepy i wasn't awake enough to smoke <g>.
Bupropion made me too anxious & hypomanic; I wasn't smoking at the time, and haven't taken it since, so I can't really comment on its effectiveness. However, I have been on Cymbalta or a combination of SSRIs & stimulants with a similar combined effect to Bupropion for about the same period over which I reduced my smoking from >12 pipes/day to 3/day, so it's certainly possible the AD therapy helped. I have most of the data (being just a wee bit OCD), so I could probably graph it & look for a correlation.
I have had the opposite experience however: a few years ago I was taking high doses of Robaxin (a sedative/muscle relaxant). When I tapered off to zero on the Robaxin, my smoking suddenly went from occasional to 12 pipes a day or more, the equivalent of a two-pack+ cigarette habit.
Specifically in answer to your questions:
> 1. Have you ever experienced a spontaneous (i.e. you weren't trying to quit) decrease in your smoking as a result of a medication or supplement? What were you taking, how large was the decrease?
[TP] - Not as such, but see above for a _possible_ effect of SNRI therapy.
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> 2. If you quit, or have tried to quit in the past, or whatever, what worked and what didn't work? In my experience bupropion didn't help me quit, and nicotine patches didn't substantially help either.
>
[TP] - Cognitive-behavioural counseling & tracking my smoking with a determination to reduce it substantially helped. The patch doesn't help me, but nicotine gum helped considerably for a while. As a pipe smoker, my addiction is somewhat different to most cigarette smokers: I'm used to a heavy dose of nicotine followed by 2-4 hours of abstinence. So I wound up chewing 2 4mg pieces of gum at a time, and now I have a huge tolerance to nicotine, an addiction to gum, and my my smoking is on the rise (but still way below the worst above, I average 3-4 pipes a day = 6-8 g of tobacco, very roughly 15-20 cigarettes worth).> 3. If you're still smoking, why? Is it motivation to quit, is it withdrawal, is there something about smoking that you are deeply attached to, does it affect you positively in other ways?
>
[TP] - I enjoy pipe smoking in moderation, there are many behavioural components that I am attached to, and good tobacco has much of the mystique of fine wine for me. Smoking definitely has a positive effect on my mood, partly because (as I understand) tobacco smoke contains natural MAOI's, and nicotine itself may have an indirect dopaminergic effect. Although I have a high tolerance to nicotine, I don't think physical withdrawal is an important component in keeping me smoking (although psychology withdrawal definitely IS); a relatively small dose of NRT such as gum or inhalers is enough to get me past the physical withdrawal.> Anything else you care to share would help me as I'm doing my research. It is remarkable how little alternative treatments for tobacco addiction have been researched...
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[TP] - Agreed. I'm very interested in any conclusions you may come to. Very few therapists seem to know that a large component of actual smoking addiction is not directly due to nicotine, but the MAOI effect on dopamine, hence the only-moderate success of nicotine replacement therapy by itself. Wellbutrin/Zyban combined with NRT & possibly dietary supplements would seem to be a treatment of choice if my theory is correct.
> Uncouth
poster:Tony P
thread:1006014
URL: http://www.dr-bob.org/babble/20111226/msgs/1006274.html