MOOD, MAJOR DEPRESSION, AND FLUOXETINE RESPONSE IN CIGARETTE SMOKERS

Objective: Two smoking cessation studies provided venues to 1) look fo r differences in affective symptoms between cigarette smokers with and without a history of major depression or other psychiatric diagnoses who were not currently depressed and 2) evaluate the efficacy of fluox etine in ameliorating affective symptoms in smokers with a history of major depression but not currently depressed. Method: Part I: Three hu ndred sixty-eight smokers who enrolled in a smoking cessation treatmen t study completed baseline self-rating scales. The relationship betwee n the scale scores and a history of major depression and other psychia tric diagnoses was examined. Part II: Thirty-nine smokers with a histo ry of major depression were enrolled in a randomized double-blind stud y that examined the utility of fluoxetine as art aid to smoking cessat ion. Self-rated scales were compared at baseline and after 3 weeks of medication treatment before the attempt to quit. Results: A history of major depression had significant main effects across all scale scores ; subjects with such a history rated themselves as more symptomatic. T he effects of other psychiatric diagnoses were neither as pervasive no r as robust. There were no differences in baseline scores between the fluoxetine- and placebo-treated groups and no change within the placeb o group after 3 weeks. There was significant improvement from baseline in several subscale scores for the group treated with fluoxetine. How ever, comparison of the score changes for the placebo and fluoxetine g roups did not show a statistically significant difference, which limit ed the ability to conclude that active treatment was better than place bo. Conclusions: Subjects with a history of major depression, but with out current affective illness, reported themselves to be more symptoma tic than those without such a history. Furthermore, in a group of smok ers with a history of major depression, affective symptoms, without co ncurrent syndromal illness, may be ameliorated by treatment with fluox etine.