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Pharmacology · single question

A patient who smokes is being treated for depression with fluoxetine (an SSRI). Which statement about fluoxetine and smoking cessation is most accurate?

  1. Fluoxetine does not have evidence supporting smoking cessation efficacy
  2. Fluoxetine is a first-line medication for smoking cessation
  3. Fluoxetine is equally effective as varenicline for smoking cessation
  4. Fluoxetine should be combined with nicotine replacement therapy for maximum effect
Show answer and explanation

Correct answer: A. Fluoxetine does not have evidence supporting smoking cessation efficacy

Fluoxetine (Prozac) is a selective serotonin reuptake inhibitor (SSRI) used for depression, OCD, and anxiety disorders. Despite early interest in antidepressants for smoking cessation (due to the dopaminergic component of nicotine addiction), clinical trials have not demonstrated that fluoxetine aids in smoking cessation. The first-line pharmacological agents for smoking cessation are: (1) varenicline (Chantix) — partial nicotinic receptor agonist, most effective; (2) bupropion (Zyban) — NDRI antidepressant with proven cessation efficacy; and (3) nicotine replacement therapy (NRT). Fluoxetine is NOT approved by the FDA for smoking cessation.

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