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antidepressants

Interaction
The medicines information centre at RGH has been asked many times for advice on the most appropriate medication to aid smoking cessation in a patient with a diagnosis of depression. With the recent listing of nicotine replacement patches for subsidised supply through the Pharmaceutical Benefit Scheme for concession card holders, it is timely to review important clinical interactions with the three currently available therapeutic agents used as an aid to smoking cessation and their use in combination with antidepressant therapy.

The three available agents: buproprion (Zyban®), nicotine replacement therapy (NRT) and varenicline (Champix®); all have similar efficacy rates in assisting with smoking cessation. Regular counselling and support (such as via the Australian government sponsored Quitline, telephone 137848) is known to increase quit rates (with or without additional pharmacological treatment) as these approaches aid motivation and provide behavioural skills to enable continued abstinence.

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A joint initiative of the Patient Services Section and the Drug and Therapeutics Information Service of the Pharmacy Department, Repatriation General Hospital, Daw Park, South Australia. The RGH Pharmacy E-Bulletin is distributed in electronic format on a weekly basis, and aims to present concise, factual information on issues of current interest in therapeutics, drug safety and cost-effective use of medications.
Editor: Assoc. Prof. Chris Alderman, University of South Australia – Director of Pharmacy, RGH © Pharmacy Department, Repatriation General Hospital, Daw Park, South Australia 5041.

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InteractionThat’s got to be one of the better titles for a blog post! But it is quite a serious topic and is an effect that may occur in up to 40% of bipolar patients with antidepressants.

From the bulletin:

The treatment with antidepressants may be associated with the induction of episodes of mania or hypomania in 15-40% of bipolar patients. The phenomenon of abnormal mood elevation during antidepressant treatment, or ‘treatment-emergent affective switch’ was first described in association with tricyclic antidepressants, and has now been reported for all major antidepressant classes.

Read it all here:

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