Smoking tobacco products is harmful to your overall wellbeing. Those who smoke face added risks than others who do not smoke. Smokers find it difficult to quit; this is mainly because of their addiction to nicotine. If you are habituated to smoking every day, you may find it difficult to stop smoking all of a sudden. Owing to the dependence on nicotine, most smokers are never successful with their first attempt to quit smoking. Can tricyclic antidepressants such as nortriptyline help you quit the tobacco smoking habit? It becomes essential to know the details before starting your tobacco cessation program.

Quitting the smoking habit can improve health and can keep cardiac problems at bay. Not stopping with heart ailments, stopping to smoke can reduce the risks of autoimmune conditions such as cancers, lung-related disorders, etc. But, quitting is not an easy task. Be it an occasional smoker or a pack-per-day smoking-addict, it is a difficult thing to do for all. This is mainly because of the addictive nature of this habit. Smoking can be both psychologically as well as physically addictive. A key chemical that makes you remain addicted is a substance called nicotine.

An abrupt discontinuation of smoking may often lead to signs of withdrawal as well as an incessant craving to smoke more. This is mainly due to the feel-good sensation your brain gets each time you light up a tobacco product. In most cases, smokers begin the habit to manage their stress or anxieties; by quitting this habit, they may need to look for other ways to manage these feelings.

In order to come out of this addictive habit, you may also need to alter your routine accordingly. It is a good practice to consult with a therapist and set time-bound goals to go tobacco-free. It is necessary to set a date by when you intend quitting. It is equally important to tell your friends and family of your intention to quit. As noted above, it is not going to be an easy thing; so expect challenges in the first few months. For example, you are likely to witness a relapse of urges to smoke soon after stopping the habit. You may also witness signs of nicotine withdrawal in the first few weeks. These signs can become acute if you had been a long term smoker. In this light, maintain a journal to track triggers.

Nortriptyline – Can it help you to quit smoking?

This med is a tricyclic antidepressant used for the treatment of depression. This drug is taken along with other drugs; a combination of meds is known to treat mental health conditions like depression and anxieties (or related disorders) better. Active ingredients of antidepressants help boost the presence of a few neuro transmitters. As a result, you are likely to get relief from mental problems within a few weeks into your medication plan. This antidepressant is also available in a generic form; its generic version costs lesser than many other branded formulations.

The odds of your quitting the smoking habit are high when you use nortriptyline. The chances of tobacco cessation are known to double over the mid to long term. The best part is this drug is – it is free of nicotine and hence is rightly placed to stop cravings among smokers. It is available in multiple dosage forms namely, 10 milligrams (mg), 25 mg, 75mg, 100 mg, etc. The drug may a take a few weeks to start tobacco cessation. Hence, if you intend to end smoking on a specific date, start taking nortriptyline at least 2 to 4 weeks prior to this quit date. This practice prepares your body to stop the habit completely by the time you reach the date set for quitting.

Safe administration of nortriptyline and precautions needed

The initial dosage is maintained at a low level of 25 mg per day. However, as you near your quit date, dosages are gradually increased. However, the maximum strength of dosage must never exceed 75 mg within a 24-hour timeline. Duration of the medication plan may last upto 3 to 4 months. But, in some cases wherein the smoking habit is deeply rooted, dosage plans may last for more than 20 weeks. You are advised to swallow the tablet with a few ounces of water. It is not a safe practice to chew or crush the pills. You may take these pills either before or after a meal. In order to get better results, take the pill at the same timeslot every day. Also, never stop taking nortriptyline till your treating physician advises you to discontinue the treatment plan. Moreover, while bringing the medication plan to a close, your doctor may taper the strength of doses before ending the tobacco cessation treatment.

You are likely to witness intense spells of dizziness and drowsiness; as a result, you may find it difficult to remain focused. You are hence advised to keep away from activities that need a high level of mental focus and / or concentration. For instance, never engage in driving or perform activities such as working on heavy machinery, sporting actions like swimming, cycling or jumping. Dizziness may often be accompanied by blurred eyesight, being anxious, etc. So, never use sharp tools or equipment such as saws, hammers, scissors, etc.

As you take this tricyclic antidepressant for tobacco cessation, you may witness a few undesired and unintended side effects. These include dryness of mouth, abdominal ailments such as nausea, vomiting or indigestion, severe spells of migraines as well as difficulties to pass stool. Those who are experiencing such difficulties (to pass stool) may be advised to take stool softeners or laxatives. You are advised to take such meds only over a short time span. Long term intake of laxatives / stool softening meds can be habit forming. Once a habit is formed, you may need to take such drugs to pass stools. Instead of relying excessively on meds, switch to a fiber rich diet containing vegetables, fruits and nuts. Also, say no to spicy or excessively fried foods.

Other needful precautions to be aware of

Nortriptyline can cause allergic reactions; such discomforts are more pronounced among people who have prior allergies or hypersensitivity to tricyclic antidepressants and their active ingredients. It is a safe practice to keep your caregiving team abreast of known / possible allergies. If you are experiencing adverse reactions such as swelling of body parts, fever, skin conditions such as hives or rashes, seek medical help on an emergency basis. Those who live in the US are advised to dial 911 without much delay; Americans may also reach out to the emergency helplines of the food and drug administration (FDA). It is essential to know that the FDA runs its own helplines to offer urgent medical help to those who develop adverse side effects soon after taking drugs this agency has approved. Those living in Canada can call Health Canada or head towards a poison control unit on an urgent basis.

Conclusive evidences are not available to establish safety of fetus of women who are pregnant. Hence, nortriptyline is very rarely given to women who are pregnant. However, if women are addicted to smoking habit, this drug is prescribed when the benefits far outweigh adverse reactions and associated risks. On the other hand, if you are planning for pregnancy, it is a safe practice to use birth control measures during your medication plan. Talk to your doctor to know more of contraceptives and how to use them to avoid accidental pregnancies.

People who are having suicidal thoughts or self-harming instincts must take added precautions. Intake of this drug may bring more such thoughts – especially among women and younger adults. It is to counter such risks this drug must always be given to those aged 25 years and above. Also, if you are already living with mental conditions like phobias, your doctor must understand mental health and clinical history. Moreover, as chemicals used in this tricyclic antidepressant can cause faster heartbeats, those who have had a heart attack or currently living with any cardiac ailments must talk to their physician about such conditions.

The drug may cause a few severe side effects among elders – i.e., those aged above 55 years. Aged people may see severe episodes of drowsiness as well as dizziness. Also, risks of being demented run quite high in elderly users. As this drug does have a lot of similarities with anticholinergics (another class of drugs), added precautions are needed among older people. Upon witnessing extreme levels of confusion, faster pulse rates or abnormal heartbeats, inform the caregiver without any delay.

In sum, tricyclic antidepressant nortriptyline can help quit the smoking habit. As it is free of any traces of nicotine, it can reduce cravings in a substantial manner. It may however need many weeks to bring about tobacco cessation. It is a safe practice to start taking it a few weeks before the date set as your quitting time. The drug however causes a few side effects such as constipation, nausea or vomiting. Those who experience difficulties to pass stools need to talk to their doctor. It is relatively harmless to start taking foods that are high on fiber; examples of such foods include fruits, nuts as well as vegetables.

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