Naltrexone, Rimonabant,
And Quitting Smoking

Often, a new pharmaceutical is tested for one thing and ends up performing well for something else. That's the case with Naltrexone and Rimonabant, two drugs that have been shown to help people stop smoking, but two drugs that have gone different paths.

Naltrexone was initially approved as an alcohol dependence drug in 1994. It wasn't until years later that it was seen as a potential benefit in weight loss, and, as a sidebar, then discovered to work well in helping people stop smoking, especially heavy drinkers.

What Naltrexone does is blocks some effects of endogenous opioids, which are part of the chemical system in the brain that creates a sense of reward and helps reduce pain. In a 2005 study, 400 patients who smoked at least one pack of cigarettes a day were tested. All patients were treated with a nicotine patch and were randomly assigned to receive placebo, 25 mg, 50 mg or 100 mg of naltrexone daily. The lower doses reduced weight gain during treatment, but did nothing for smoking. However, once they got to the 100mg level, improvement in the odds of quitting smoking improved drastically for those who completed the treatment.

In a follow up study completed in 2008 at the University of Chicago, it was found that Neltrexone did indeed seem to reduce smoking. As stated by Andrea C. King, a psychologist and associate professor in the department of psychiatry at the university and first author of the study. "We examined smokers who did not have any other current addiction - besides tobacco - or mental or medical disorders, which may have confounded the results. The range of alcohol drinking was from abstainer to heavy social drinker.

Naltrexone, at 50 mg oral daily, when added to counseling and patch, significantly decreased heavy drinking rates in smokers enrolled in smoking cessation," said King. "Persons with the heaviest drinking patterns appeared to benefit the most from naltrexone, in terms of alcohol and smoking outcomes; it also increased their quit rates more so than in lighter drinkers." One other thing from the study showed that this drug works better on women than men.

Rimonabant has been shown to also help stop smoking, but it's problems include not only not doing enough testing, but charges of severe depression and suicide. It's another drug that was originally being tested as a weight lost drug, and had its smoking cessation properties discovered. In studies done in both 2004 and 2005 they seemed to indicate that this drug could help smokers while also dealing with the possibility of gaining weight.

However, in 2006, the Food and Drug Administration turned down their request for approval, worried about the side effects, and in 2008 it was recommended by the European Medicines Agency that physicians not prescribe it for the same reasons, even though they had previously approved its usage in small doses in 2006. As of this time, it's supposed to be off the market.

Still, both drugs are available on the internet, so this is a warning to those who might be thinking of using them for purposes of smoking cessation. Neither has been officially approved for use, and in the case of one of them, could cause serious problems on the back end.

© Smoke Not So Much 2009

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