A Dementia Drug for Smoking Cessation?


This is the Medscape Psychiatry Minute. I am Dr. Peter Yellowlees. There is a need to identify medications to aid smoking cessation. We know that endogenous acetylcholinesterase levels play an important role in smoking behavior and cognition, especially in relation to withdrawal-related cognitive deficits. A team of investigators from the University of Pennsylvania, in a pilot feasibility study, have tested whether an acetylcholinesterase inhibitor can enhance cognitive performance in smokers. In this pilot study, 18 non-treatment-seeking healthy smokers received either donepezil 5 mg or placebo for 4 weeks. Smoking rate, side effects, and the neurocognitive measures of working memory and sustained attention were assessed weekly. Researchers found that the donepezil group was superior on working memory (P = .03) and marginally better on sustained attention (P = .03). They concluded that donepezil may have procognitive effects on healthy smokers while they continue to smoke as usual. Given the association between cognitive deficits and relapse, it seems that acetylcholinesterase inhibitors should be explored as potential therapeutic agents for smoking cessation. This article is selected from Medscape Best Evidence. I am Dr. Peter Yellowlees.

Abstract