Nortriptyline | Clonidine | Mecamylamine | Naltrexone | Monoamine oxidase inhibitors | Rimonabant and nicotine vaccine
Nortriptyline is a tricyclic antidepressant that has been shown
in several double-blind, placebo-controlled trials to be superior
to placebo (Hall et al. 1998; Prochazka et al. 1998)
and to have comparable efficacy to bupropion (Hall et al. 2002). Its efficacy may be improved with higher- rather than
lower-intensity behavioral therapies. Its mechanism of action is
thought to relate to norepinephrine and serotonin reuptake blockade.
Side effects include dry mouth, blurred vision, constipation, and
orthostatic hypotension. Nortriptyline appears to have some utility
for smokers with past histories of major depression, but its potential
for fatal overdose has likely limited its utilization. Nonetheless,
it can be recommended as a second-line agent after nicotine replacement
therapies and bupropion, though more study of this agent is necessary.