How To Stop Nicotine Replacement Theraphy

Stopping Nicotine Replacement Therapy

As mentioned before, most forms of NRT should be used for limited periods of time, and are often tapered down to a low dose before being stopped. Research is still being done to refine the use of NRT. For example, even though the patch is usually used for 3 to 5 months, some studies have suggested that using it for 8 weeks or less works just as well. However, other researchers have noted that the risk of relapse goes up when nicotine replacement is stopped, even after it has been used for 5 months. These differences have not been fully explained. More studies are needed to learn which smokers are likely to be successful using shorter or longer NRT than usual. If you feel that you need NRT for a different length of time than is recommended, it is best to discuss this with your doctor.

Bupropion (Zyban®)

Bupropion (Zyban®) is a prescription antidepressant in an extended-release form that reduces symptoms of nicotine withdrawal. It does not contain nicotine. This drug acts on chemicals in the brain that are related to nicotine craving. It can be used alone or together with nicotine replacement. Bupropion works best if it is started 1 or 2 weeks before the quit date. The usual dosage is one or two 150 mg tablets per day.

This drug should not be taken if you have ever had seizures, heavy alcohol use, serious head injury, bipolar (manic-depressive) illness, anorexia or bulimia (eating disorders).

Some doctors may recommend combination drug therapy for heavily addicted smokers, such as using bupropion along with a nicotine replacement patch and/or a short-acting form of nicotine replacement (such as gum or lozenges).

Varenicline (Chantix™)

Varenicline (Chantix™) is a newer prescription medicine developed for the sole purpose of helping people stop smoking. It works by interfering with nicotine receptors in the brain, which has two effects. It lessens the pleasurable physical effects a person gets from smoking, and it reduces the symptoms of nicotine withdrawal.

Several studies have shown varenicline can more than double the chances of quitting smoking. Some studies have also found it may be more effective than bupropion, at least in the short-term.

Reported side effects of varenicline have included headaches, nausea, vomiting, trouble sleeping, unusual dreams, flatulence (gas), and changes in taste. There have also been reports of depressed mood, thoughts of suicide, attempted suicide, and changes in behavior in people taking varenicline. People who have these problems should contact their doctors right away. Although these side effects may happen, varenicline is usually well-tolerated. Since varenicline is a newer drug, research has not been done to find out if it is safe to use along with nicotine replacement products.