From the Research
Nicotine patches are not the primary treatment for later disorder conditions, but varenicline has shown to be more effective in maintaining abstinence and reducing craving than bupropion and nicotine replacement therapy (NRT) 1.
Primary Considerations
When considering the use of nicotine patches for later disorder conditions, it's essential to prioritize the most recent and highest quality study, which suggests that varenicline may be a better option for smoking cessation, especially in individuals with major depressive disorder (MDD) 1.
- The study found that varenicline had a greater efficacy effect size compared to bupropion, NRT, and placebo, with similar risk of neuropsychiatric adverse events (NPSAEs) 1.
- Varenicline is a partial agonist for α4β2 nicotinic acetylcholine receptors, which helps reduce craving and withdrawal symptoms 2.
- Bupropion, on the other hand, is a norepinephrine and dopamine reuptake inhibitor, which can also help with smoking cessation, but may have a lower efficacy rate compared to varenicline 2.
Treatment Recommendations
Based on the available evidence, varenicline is recommended as the primary pharmacotherapy for smoking cessation, especially in individuals with MDD, due to its greater efficacy effect size and similar risk of NPSAEs 1.
- The typical dosage of varenicline is 1mg twice daily, starting 1 week before the quit date 1.
- Nicotine patches, on the other hand, can be used as an alternative or adjunct therapy, with a typical dosage starting at 21mg for those smoking more than 10 cigarettes daily, applied once daily upon waking and removed before bedtime 3.
- It's essential to note that nicotine patches are primarily for smoking cessation and should be used for later disorder conditions only under medical supervision, as other treatments like cognitive behavioral therapy or specific medications may be more appropriate.