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RESEARCH: Paul Aveyard, Carol Johnson, Sally Fillingham, Amanda Parsons, and Mike Murphy Nortriptyline plus nicotine replacement versus placebo plus nicotine replacement for smoking cessation: pragmatic randomised controlled trial BMJ 2008; 0: bmj.39545.852616.BEv1 [Abstract] [Full text]

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Correction

Paul Aveyard   (30 April 2008)

Nortriptyline for smoking prevention: what are the doses?

Om Prakash   (1 May 2008)

Correction 30 April 2008
Paul Aveyard, NIHR Career Scientist University of Birmingham B15 2TT Send response to journal: Re: Correction	I have just noticed an error that resulted from the in-house editing at the BMJ that I did not spot at the proof stage. The Abstract conclusion said 'Nortriptyline and NRT are both effective medications in smoking cessation but the effect of the combination is less than the sum of the parts and there is no evidence that combination treatment is more effective than either alone.' It has been transposed to 'Nortriptyline and nicotine replacement therapy are both effective for smoking cessation but the effect of the combination is less than either alone and evidence is lacking that combination treatment is more effective than either alone.' This latter is wrong, because the effect of the combination is not less than either alone. If there is an added benefit from combination treatment the effect is small if it exists at all. The evidence is strong that combination is not less effective than either alone. Competing interests: I have been paid by McNeill, Pfizer, and Xenova for consultancy work in smoking cessation.
Nortriptyline for smoking prevention: what are the doses? 1 May 2008
Om Prakash, Assistant Professor of Psychiatry Geriatric Clinic & Services, Department of Psychiatry, NIMHANS, Bangalore, INDIA Send response to journal: Re: Nortriptyline for smoking prevention: what are the doses?	The study by Aveyard and his collegues (1) has given new insights into the role of nortriptyline in nicotine addiction. The adequate sample size and methodology has taken out varied flaws of earlier studies (2-3). However, some concerns persist. Firstly, the rational of keeping the doses of nortryptiline up to 75mg is not clear though therapeutic doses for depression much higher. Secondly, for better understanding of the effect of nortryptiline, the one fifth of group (that excluded, mainly because they were taking other antidepressants) can become another control group probably without extra intervention. Nevertheless, this study has open new avenues for better interventions for prevention of smoking. REFERENCES 1.Paul Aveyard, Carol Johnson, Sally Fillingham, Amanda Parsons, and Mike Murphy.Nortriptyline plus nicotine replacement versus placebo plus nicotine replacement for smoking cessation: pragmatic randomised controlled trial BMJ 2008; 0: bmj.39545.852616.BEv1 2.Hall SM, Humfleet GL, Reus VI, Munoz RF, Cullen J. Extended nortriptyline and psychological treatment for cigarette smoking. Am J Psychiatry 2004;161:2100-7. 3.Prochazka AV, Kick S, Steinbrunn C, Miyoshi T, Fryer GE. A randomized trial of nortriptyline combined with transdermal nicotine for smoking cessation. Arch Intern Med 2004;164:2229-33. Competing interests: None declared