Treatment of Cigarette smoking and How to quit smoking Nicotine Replacement Therapy (NRT), bupropion hydrochloride (sustained release), and varenicline tartrate are the primary medications used in Smoking treatment options and smoking cessation medicines by the best psychiatrist in india. Nicotine Replacement Therapy (NRT) - Nicotine addiction treatment - NRT began with nicotine gum in 1984 and now includes gum, nasal spray, inhaler, lozenge, sublingual tablet, and transdermal patches. - Mechanism : NRT delivers nicotine through oral or nasal mucosa or transdermally, helping to alleviate withdrawal symptoms and reduce the urge to smoke in smoking cessation treatment. - Types and Duration : - Short-acting formulations (e.g., gum, nasal spray) mimic the effects of cigarette smoking and are used as needed in Quit smoking treatments. - Long-acting formulations (e.g., patches) provide a continuous release of nicotine over 16-24 hours. - Efficacy : - NRT significantly increases smoking cessation rates compared to placebo as per the top psychiatrist in india. - psychiatrist in jaipur opine that combination of the patch and a short-acting formulation is more effective than using either alone. - Dosage and Duration : - Higher doses of NRT (e.g., 4 mg nicotine gum vs. 2 mg) show increased effectiveness. - Longer treatment durations (>8 weeks) do not provide additional benefit, and tapering the dose does not improve outcomes significantly. - Adverse Effects : NRT generally causes mild side effects like irritation at the site of administration. No increased cardiovascular risk was noted by best psychiatrist in jaipur among smokers with a history of heart disease. Bupropion - Approved for smoking cessation in 1997 after initial observations of smokers quitting while taking the medication for depression. - Mechanism :Inhibiting the reuptake of dopamine, norepinephrine, and serotonin and also antagonizes nicotinic acetylcholine receptors (nAChRs). - Dosing : Typically administered as 150 mg twice daily of the sustained-release formulation for 7-12 weeks. - Efficacy : - A 2014 review by a psychaitrist in India found bupropion significantly increases long-term smoking cessation rates. - Jaipur psychiatrist found similar effectiveness is seen with both 150 mg and 300 mg doses, and it works equally well in both men and women. - It is effective for both smokers with and without depression. - Side Effects : Bupropion is generally well-tolerated, with common side effects including dry mouth and insomnia. The risk of seizures is low (1:1000). - Combination with NRT by psychiatrist jaipur was more effective than either treatment alone. Varenicline - FDA Approval : Varenicline, a partial agonist at nAChRs, was approved for smoking cessation in 2006. - Mechanism : Varenicline selectively binds to a4b2 nAChRs, stimulating dopamine release to reduce withdrawal symptoms and blocking nicotine’s rewarding effects. - Dosing : Standard dosing is 1 mg twice daily, starting a week before the quit date. - Efficacy : - Best psychiatrist jaipur found it to be more effective than placebo, with a two- to three-fold increase in smoking cessation rates. - A psychiatric doctor meta-analysis found varenicline superior to both NRT and bupropion in promoting smoking cessation. - Patients in the varenicline group made quit attempts sooner than those in the placebo group. - Adverse Effects : The most common side effect is nausea (6-51%), which is dose-dependent. There is no significant increase in psychiatric events (e.g., depression, suicidal ideation) compared to placebo, although best psychologist in jaipur advise caution in individuals with a history of psychiatric disorders. Comparing NRT, Bupropion, and Varenicline - Efficacy : All three medications (NRT, bupropion, and varenicline) are effective for smoking cessation with low side-effect profiles. According to the best psychiatrist doctor in jaipur, Varenicline tends to be the most effective, followed by NRT and bupropion. - Combination Therapy : Combining NRT with bupropion or varenicline might offer added benefits, although some studies by famous psychiatrist in jaipur show limited benefit from adding bupropion to NRT. - Long-term Effects : There is a need for further top psychologist research on the long-term effects of these medications, especially regarding relapse prevention. -Behavioral and Psychological Approaches: Psychological methods to quit smoking Cognitive behavioral therapy for smoking cessation Smoking cessation group therapy Support for quitting smoking Online smoking cessation support Self-help for quitting smoking -Relapse Prevention: Prevent smoking relapse Long-term smoking cessation Coping with cravings Dealing with nicotine withdrawal symptoms