The proposed research is a treatment-matching study to test whether adding fluoxetine pharmacotherapy to behavioral cessation treatment improves the depression-prone smoker's ability to quit. The investigators will randomize 144 smokers with a prior history of depression and 206 smokers who lack such a history to a double-blind treatment with either 60 mg fluoxetine or placebo, while they undergo cognitive behavioral treatment to quit smoking. The main study outcome is biologically verified abstinence 6 months after treatment. The administration of placebo and fluoxetine would begin 3 weeks before the quit smoke date and will continue for 2 months post-quit date (totaling 11 weeks on drug/placebo). Cognitive behavioral treatment will be weekly before quitting and biweekly after quitting. There will be monthly follow-up evaluations for six months after the quit date. The research tests both the Selective Benefit Hypothesis and the Generalized Benefit Hypothesis of fluoxetine's effects is theoretically and clinically important. The mechanism of action is that the drug diminishes compulsive smoking behavior, obsessional cigarette craving, and nicotine withdrawal dysphoria that occur independently of depressive vulnerability. The significance of this research is that it evaluates a humane, potentially cost-effective treatment for nicotine dependence in depression-prone smokers, and may advance understanding of shared predisposing factors that generate this comorbidity.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL059348-04
Application #
6351524
Study Section
Special Emphasis Panel (ZRG2-HUD-3 (01))
Program Officer
Jobe, Jared B
Project Start
1998-02-01
Project End
2003-01-31
Budget Start
2001-02-01
Budget End
2003-01-31
Support Year
4
Fiscal Year
2001
Total Cost
$155,693
Indirect Cost
Name
Edward Hines Jr VA Hospital
Department
Type
DUNS #
City
Hines
State
IL
Country
United States
Zip Code
60141
Pagoto, Sherry L; Spring, Bonnie; McChargue, Dennis et al. (2009) Acute tryptophan depletion and sweet food consumption by overweight adults. Eat Behav 10:36-41
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Spring, Bonnie; Doran, Neal; Pagoto, Sherry et al. (2007) Fluoxetine, smoking, and history of major depression: A randomized controlled trial. J Consult Clin Psychol 75:85-94
Cook, Jessica Werth; Spring, Bonnie; McChargue, Dennis (2007) Influence of nicotine on positive affect in anhedonic smokers. Psychopharmacology (Berl) 192:87-95
Hitsman, Brian; Spring, Bonnie; Pingitore, Regina et al. (2007) Effect of tryptophan depletion on the attentional salience of smoking cues. Psychopharmacology (Berl) 192:317-24
Sanchez-Johnsen, Lisa; Ahluwalia, Jasjit S; Fitzgibbon, Marian et al. (2006) Ethnic similarities and differences in reasons for smoking. Addict Behav 31:544-8
Hitsman, Brian; Spring, Bonnie; Wolf, William et al. (2005) Effects of acute tryptophan depletion on negative symptoms and smoking topography in nicotine-dependent schizophrenics and nonpsychiatric controls. Neuropsychopharmacology 30:640-8
Sanchez-Johnsen, Lisa A P; Fitzgibbon, Marian L; Ahluwalia, Jasjit S et al. (2005) Eating pathology among Black and White smokers. Eat Behav 6:127-36
Borrelli, Belinda; Papandonatos, George; Spring, Bonnie et al. (2004) Experimenter-defined quit dates for smoking cessation: adherence improves outcomes for women but not for men. Addiction 99:378-85
Cook, Jessica Werth; Spring, Bonnie; McChargue, Dennis E et al. (2004) Influence of fluoxetine on positive and negative affect in a clinic-based smoking cessation trial. Psychopharmacology (Berl) 173:153-9

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