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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by JayBTV2 on March 2, 2010, at 7:34:01
I've read in a few places (wish I had links) that some people think being on an MAOi like Parnate or Nardil would make quitting smoking easier. I guess since part of the "reward" of smoking is supposed to be MAO-B inhibition.
However doesn't the below study with Rats seem to suggest the opposite? I'm currently on Parnate and considering another attempt at quiting. Has anyone who's taken an MAOi and tried to quit find that it's helped or hurt that cause? Or even just noticed smoking more or less?
RATIONALE: The mechanisms mediating tobacco addiction remain elusive. Nicotine, the psychoactive component in tobacco, is generally believed to be the main cause of reward and addiction. However, tobacco smoke contains thousands of constituents, some of which may interact with nicotine to enhance reward. It has previously been shown that monoamine oxidase (MAO) inhibition, known to result from smoking, can enhance nicotine self-administration. The aim of the present study was to evaluate the role of noradrenergic systems in mediating this enhancement of nicotine reward. OBJECTIVE: The objective of this study was to test the hypothesis that MAO inhibitor pretreatment enhances nicotine self-administration by activation of noradrenergic pathways that regulate dopamine release in the nucleus accumbens (NAc). METHODS: The effect of prazosin (0.0625-0.5 mg/kg, i.p.), a specific alpha1-adrenergic receptor antagonist, was examined on male rats pretreated with tranylcypromine (3 mg/kg), an irreversible inhibitor of MAO A and B. Acquisition of nicotine (10 mug kg(-1) inj(-1), i.v.) self-administration behavior was examined over a 5-day period. Nicotine (60 mug kg(-1) inj(-1), i.v.)-induced increase in NAc extracellular dopamine levels was examined by in vivo microdialysis in non-self-administering animals. RESULTS: We have shown that (1) tranylcypromine enhances nicotine self-administration, (2) prazosin pretreatment blocks both the acquisition and the expression of nicotine self-administration, and (3) prazosin pretreatment diminishes nicotine-induced dopamine release in the NAc. CONCLUSION: These data indicate that the stimulation of alpha1-adrenergic receptors is critical for tranylcypromine enhancement of nicotine reward and suggest a critical interplay between the noradrenergic and dopaminergic systems in tobacco addiction.
Posted by Phillipa on March 2, 2010, at 11:14:33
In reply to Quitting Smoking on MAOIs (Help Interpret Study), posted by JayBTV2 on March 2, 2010, at 7:34:01
In all seriousness any idea why some just hate smoking and it's makes them nervous and not better? Thanks Phillipa
Posted by linkadge on March 2, 2010, at 16:22:35
In reply to Re: Quitting Smoking on MAOIs (Help Interpret Study) » JayBTV2, posted by Phillipa on March 2, 2010, at 11:14:33
This study doesn't really specify whether MAOI's will improve or hinder smoking cessation efforts.
It basically says that an MAOI makes the effects of nicotine more pleasurable and that this effect can be blocked with an norepinephrine receptor antagonist.
This says to me that the effects of nicotine are not identical to those of smoking (as smoking contains MAOI compounds) which will enhance the pleasure of smoking. So nicotine + maoi is more pleasurable than nicotine alone.
This study might suggest that an MAOI administered with nicotine replacement might be more similar to smoking than nicotine alone - so this could enhance smoking cessation attempts.
On the other hand, the strategy might backfire. If the patient does happen to smoke while taking the MAOI they may find the cigarette more pleasurable and hence want to smoke more.
Substituting one drug for another can be tricky. Like substituing benzo's for alcohol. Somtiems its works well, sometimes the patient abuses both.
I think what it does say though, is that if the patient does infact fully refrain from smoking, the MAOI and nicotine will help replace the effect of smoking more completely than nicotine alone.
Linkadge
Posted by JayBTV2 on March 2, 2010, at 20:23:22
In reply to Re: Quitting Smoking on MAOIs (Help Interpret Study), posted by linkadge on March 2, 2010, at 16:22:35
Interesting - thanks a lot for the breakdown.
Posted by desolationrower on March 5, 2010, at 23:17:15
In reply to Re: Quitting Smoking on MAOIs (Help Interpret Study), posted by linkadge on March 2, 2010, at 16:22:35
link sounds right to me
-d/r
ps i didn't find nicotine more enjoyable when on parnate. i took if via lozenge for adhd
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