Does trazodone help with smoking cessation? (2+ factors)

In this article, we will discuss whether trazodone helps in smoking cessation, how trazodone helps in smoking cessation, what factors may affect smoking cessation with trazodone, what alternatives to trazodone are used for smoking cessation, and what non-pharmacological approaches are used to stop smoking.

Does trazodone help with smoking cessation?

Yes, trazodone may help with smoking cessation when used in combination with nicotine patches. Trazodone is primarily used as an antidepressant, and while regulatory bodies do not officially approve it for smoking cessation, some studies suggest its potential to aid individuals in quitting smoking. (1)

Trazodone belongs to the serotonin modulators and works by inhibiting the serotonin transporter and serotonin type-2 receptors. It is mainly prescribed to treat major depressive disorders, anxiety, and insomnia. (2)

However, the effectiveness of trazodone varies from person to person, and its use in stopping smoking is considered off-label.

How does trazodone help with smoking cessation?

Trazodone’s potential benefits for smoking cessation may be due to its ability to regulate serotonin in the brain. By influencing serotonin, trazodone may help alleviate withdrawal symptoms and cravings associated with quitting smoking.

Symptoms of smoking withdrawal: (8)

• Anger
• Depression
• Anxiety
• Insomnia
• Restlessness
• Increased appetite

Trazodone increases serotonin in the brain by inhibiting serotonin reuptake and blocking histaminic and alpha-1-adrenergic receptors, alleviating the depression experienced by the individual experiencing nicotine withdrawal.

Its sedative properties may help individuals manage the anxiety and insomnia experienced during the cessation process. (1)

What does research suggest?

Research on the efficacy of trazodone for smoking cessation is limited. Some studies suggest a potential benefit of using trazodone along with nicotine replacement therapies (NRTs) to quit smoking.

A study was done on 286 participants who were prescribed trazodone along with their preferred NRT, 33 selected nicotine patches, 99 selected nicotine gums, and 64 selected microtabs. The study concluded that nicotine patches, along with trazodone, had the highest success rate for smoking cessation. (1)

However, there is a need for further research to establish a clearer understanding of trazodone’s role in smoking cessation.

What factors can affect smoking cessation with trazodone?

Trazodone shows promise for helping with smoking cessation, but several factors can influence its effectiveness.

• Individual variabilities: Individual factors like genetics, pharmacodynamics, and the severity of nicotine addiction can influence trazodone’s effectiveness in aiding smoking cessation.

• Overall health: Pre-existing medical conditions may impact the efficacy of trazodone in helping with smoking cessation. 

• Dosage: Changes in the prescribed dosage and duration can impact the response to trazodone, so adherence to the prescription is crucial for maximizing the potential benefits of trazodone in smoking cessation.

What are the alternatives to trazodone for smoking cessation?

Various pharmacological alternatives exist for individuals who may not respond well to trazodone or require alternative options due to side effects from trazodone. Medications like bupropion, nortriptyline, and varenicline are recognized and approved by health authorities for smoking cessation. Bupropion and nortriptyline show similar efficacy to NRTs in smoking cessation, but bupropion is a little less effective than varenicline. (4)

• Bupropion: It is an atypical antidepressant drug that is approved for smoking cessation. The recommended dosing regimen for smoking cessation is 150 mg once daily for three days, followed by an increase to 150 mg twice daily for 7 to 12 weeks. (5)

• Varenicline: It is a first-line pharmacotherapy for smoking cessation. It is more effective in smoking cessation in comparison to bupropion. The combination of varenicline and bupropion shows promising potential to become the best intervention for smoking cessation. (5)

• Nortriptyline: The tricyclic antidepressant nortriptyline is occasionally prescribed in cases where first‐line treatments do not work. The recommended dose is 75 to 100 mg daily for 12 weeks. (5)

What are the non-pharmacological approaches to stop smoking?

In addition to pharmacological interventions, non-pharmacological approaches play an important role in supporting individuals to quit smoking.

• Nicotine replacement therapies (NRTs): NRTs, such as patches, gums, and lozenges, are used to treat nicotine dependence. These are commonly used to wean individuals off nicotine gradually. (3)

• Behavioural therapy: Behavioral therapy helps individuals change negative thought patterns and behaviours related to smoking. (6)

• Counselling: Counselling sessions with a professional can help individuals develop coping strategies to manage cravings associated with cravings.

• Support groups: Support groups offer a sense of community and are helpful means of treating the psychological and behavioural aspects of addiction.

• Stress management: Stress management techniques can also aid in smoking cessation, as stress is a common trigger for smoking. (7)

In my opinion, trazodone shows promise for smoking cessation. It is essential for individuals considering trazodone for smoking cessation to consult healthcare professionals who can recommend personalized treatment plans.

Additionally, a combination of pharmacological and non-pharmacological approaches may offer better results for those trying to quit smoking.

References