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Management of emergent psychiatric symptoms during smoking cessation.

Abstract：

BACKGROUND:Tobacco smoking is a major risk factor for cardiovascular disease, respiratory disease and cancer and, for current smokers, smoking cessation is one of the most effective therapeutic interventions for reducing the risk of all-cause morbidity and mortality. However, smoking cessation causes nicotine withdrawal syndrome, a condition with symptoms that overlap those of major depression and anxiety disorders. SCOPE:The objective of this review was to examine the evidence that smoking cessation may be associated with new onset of psychiatric illness, particularly in individuals with no history of psychiatric disease, and to provide recommendations for the management of emergent psychiatric symptoms in smokers attempting cessation. Relevant articles were obtained from a MEDLINE search (articles indexed up to, and including, October 2008, with no historical date limit), and citation review of selected primary and review articles. FINDINGS:There is evidence that smoking cessation can result in new onset of major depressive disorder, even in individuals with no history of depression. It has also been suggested that nicotine may be used as a form of self-medication for depression, and that smoking cessation can reveal a previously undiagnosed condition. There is little evidence of an association between smoking cessation and increased risk for other types of psychiatric illness. The management of emergent psychiatric symptoms in smokers attempting abstinence is discussed. CONCLUSION:The overall health benefits of quitting smoking undoubtedly outweigh any potential side-effects associated with nicotine withdrawal. However, a well-managed quit attempt must plan for the emergence of nicotine withdrawal, monitor for symptoms of depression and psychiatric disease, and manage these conditions appropriately should they present.

journal_name

Curr Med Res Opin

journal_title

Current medical research and opinion

authors

Aubin HJ

doi

10.1185/03007990802707600

subject

Has Abstract

pub_date

2009-02-01 00:00:00

pages

519-25

issue

2

eissn

0300-7995

issn

1473-4877

pii

10.1185/03007990802707600

journal_volume

25

pub_type

杂志文章

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