Effectiveness of topiramate for tobacco dependence in patients with depression; a randomised, controlled trial

<p>Abstract</p> <p>Background</p> <p>Tobacco dependence management is a multi-component intervention that includes pharmacological treatments such as Nicotine Substitution Therapy (NST) or bupropion, and psychological therapy. There are some preliminary reports on topir...

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Main Authors: Alda Marta, Sobradiel Natalia, Campayo Javier, Mas Adoración, Andrés Eva, Magallón Rosa, Crucelaegui Arantxa, Sanz Beatriz
Format: Article
Language:English
Published: BMC 2008-05-01
Series:BMC Family Practice
Online Access:http://www.biomedcentral.com/1471-2296/9/28
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author Alda Marta
Sobradiel Natalia
Campayo Javier
Mas Adoración
Andrés Eva
Magallón Rosa
Crucelaegui Arantxa
Sanz Beatriz
author_facet Alda Marta
Sobradiel Natalia
Campayo Javier
Mas Adoración
Andrés Eva
Magallón Rosa
Crucelaegui Arantxa
Sanz Beatriz
author_sort Alda Marta
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Tobacco dependence management is a multi-component intervention that includes pharmacological treatments such as Nicotine Substitution Therapy (NST) or bupropion, and psychological therapy. There are some preliminary reports on topiramate efficacy for tobacco dependence. The aim of this study is to determine whether topiramate is as effective as the standard NST treatment for tobacco cessation at 1-year follow-up in patients with depression.</p> <p>Method/design</p> <p><it>Design: </it>A randomised, controlled trial involving two groups, one of which is the control group consisting of patients on the standard pharmacological treatment for tobacco cessation (NST) and the other is the intervention group consisting of patients on topiramate as pharmacological treatment.</p> <p><it>Setting: </it>29 primary care health centres in the city of Zaragoza, Spain.</p> <p><it>Sample: </it>180 patients, aged 18–65 years, diagnosed with major depression, smoke more than 20 cigarettes/day, who have voluntarily asked for tobacco cessation therapy.</p> <p><it>Intervention: </it>A multi-component programme for tobacco cessation is offered to all of the patients in the study. This programme is made up of pharmacological therapy + group cognitive-behavioural therapy. Pharmacological therapy consists of NST for the control group and topiramate (200 mg/day) for the intervention group. Psychological therapy is made up of 16 sessions of manualised group therapy.</p> <p><it>Measurements: </it>Cessation will be assessed by patient self-declared abstinence, expired air carbon monoxide levels, and cotinine levels in saliva. Questionnaires on tobacco dependence, anxiety, depression, impulsiveness and self-efficacy will be administered. The interviewers will not know which group the patient belongs to (blind). The assessments will be carried out at baseline, D (cessation day) -1, D+1, weeks 1, 2, 3, 4, 6, 8, 10 and 13, and months 4, 5, 6, 8, 10 and 12.</p> <p><it>Main variables: </it>Tobacco cessation rates and tobacco dependence.</p> <p><it>Analysis: </it>The analysis will be per intent to treat. We will use the general linear models of the SPSS version 15 statistical package, to analyse the effect of the treatment on the result variable (tobacco cessation rate).</p> <p>Discussion</p> <p>It is necessary to develop new and more effective pharmacological treatments for tobacco cessation. This randomised clinical trial will determine whether topiramate is effective for tobacco cessation in patients with depression.</p> <p>Trial registration</p> <p>Current Controlled Trials ISRCTN93532081</p>
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spelling doaj.art-8b8cbfbbd5dc415da86e3d08da7d6c852022-12-22T00:24:55ZengBMCBMC Family Practice1471-22962008-05-01912810.1186/1471-2296-9-28Effectiveness of topiramate for tobacco dependence in patients with depression; a randomised, controlled trialAlda MartaSobradiel NataliaCampayo JavierMas AdoraciónAndrés EvaMagallón RosaCrucelaegui ArantxaSanz Beatriz<p>Abstract</p> <p>Background</p> <p>Tobacco dependence management is a multi-component intervention that includes pharmacological treatments such as Nicotine Substitution Therapy (NST) or bupropion, and psychological therapy. There are some preliminary reports on topiramate efficacy for tobacco dependence. The aim of this study is to determine whether topiramate is as effective as the standard NST treatment for tobacco cessation at 1-year follow-up in patients with depression.</p> <p>Method/design</p> <p><it>Design: </it>A randomised, controlled trial involving two groups, one of which is the control group consisting of patients on the standard pharmacological treatment for tobacco cessation (NST) and the other is the intervention group consisting of patients on topiramate as pharmacological treatment.</p> <p><it>Setting: </it>29 primary care health centres in the city of Zaragoza, Spain.</p> <p><it>Sample: </it>180 patients, aged 18–65 years, diagnosed with major depression, smoke more than 20 cigarettes/day, who have voluntarily asked for tobacco cessation therapy.</p> <p><it>Intervention: </it>A multi-component programme for tobacco cessation is offered to all of the patients in the study. This programme is made up of pharmacological therapy + group cognitive-behavioural therapy. Pharmacological therapy consists of NST for the control group and topiramate (200 mg/day) for the intervention group. Psychological therapy is made up of 16 sessions of manualised group therapy.</p> <p><it>Measurements: </it>Cessation will be assessed by patient self-declared abstinence, expired air carbon monoxide levels, and cotinine levels in saliva. Questionnaires on tobacco dependence, anxiety, depression, impulsiveness and self-efficacy will be administered. The interviewers will not know which group the patient belongs to (blind). The assessments will be carried out at baseline, D (cessation day) -1, D+1, weeks 1, 2, 3, 4, 6, 8, 10 and 13, and months 4, 5, 6, 8, 10 and 12.</p> <p><it>Main variables: </it>Tobacco cessation rates and tobacco dependence.</p> <p><it>Analysis: </it>The analysis will be per intent to treat. We will use the general linear models of the SPSS version 15 statistical package, to analyse the effect of the treatment on the result variable (tobacco cessation rate).</p> <p>Discussion</p> <p>It is necessary to develop new and more effective pharmacological treatments for tobacco cessation. This randomised clinical trial will determine whether topiramate is effective for tobacco cessation in patients with depression.</p> <p>Trial registration</p> <p>Current Controlled Trials ISRCTN93532081</p>http://www.biomedcentral.com/1471-2296/9/28
spellingShingle Alda Marta
Sobradiel Natalia
Campayo Javier
Mas Adoración
Andrés Eva
Magallón Rosa
Crucelaegui Arantxa
Sanz Beatriz
Effectiveness of topiramate for tobacco dependence in patients with depression; a randomised, controlled trial
BMC Family Practice
title Effectiveness of topiramate for tobacco dependence in patients with depression; a randomised, controlled trial
title_full Effectiveness of topiramate for tobacco dependence in patients with depression; a randomised, controlled trial
title_fullStr Effectiveness of topiramate for tobacco dependence in patients with depression; a randomised, controlled trial
title_full_unstemmed Effectiveness of topiramate for tobacco dependence in patients with depression; a randomised, controlled trial
title_short Effectiveness of topiramate for tobacco dependence in patients with depression; a randomised, controlled trial
title_sort effectiveness of topiramate for tobacco dependence in patients with depression a randomised controlled trial
url http://www.biomedcentral.com/1471-2296/9/28
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