Pharmacology · single question

A patient taking fluoxetine wishes to stop smoking. All of the following statements are correct EXCEPT:

The patient's medication list should be reviewed for interactions before adding therapy
Smoking cessation counselling should be offered
The antidepressant the patient is already taking will also treat nicotine dependence
Nicotine replacement therapy may be considered

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Correct answer: C. The antidepressant the patient is already taking will also treat nicotine dependence

A. Reviewing interactions is always appropriate; fluoxetine is a potent CYP2D6 inhibitor.
B. Behavioural counselling is a first-line component of every cessation strategy and roughly doubles quit rates when combined with pharmacotherapy.
C. Correct — this is the EXCEPTION and the point of the question. FLUOXETINE is an SSRI with NO established efficacy for smoking cessation. The antidepressant that IS licensed for cessation is BUPROPION (Zyban), a dopamine/noradrenaline reuptake inhibitor — a different drug and a different mechanism. Do not assume one antidepressant substitutes for another.
D. Nicotine replacement (patch, gum, lozenge) is appropriate and can be combined with counselling.

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