Antidepressant pharmacotherapy helps some cigarette smokers more than others

Adult smokers (N = 253) without clinically significant depression were rand omized on a double-blind basis to receive fluoxetine (30 or 60 mg daily) or a placebo for 10 weeks in combination with cognitive-behavioral therapy (C BT). It was predicted that fluoxetine would selectively benefit smokers wit h higher baseline depression, nicotine dependence, and weight concern and l ower self-efficacy about quitting smoking. Among those who completed the pr escribed treatment regimen, baseline depression scores moderated the treatm ent response. Logistic regression analyses showed that 1 and 3 months after the quit date, fluoxetine increased the likelihood of abstinence, as compa red with placebo, among smokers with minor depression but not among those w ith little or no depression. Results suggest that, as an adjunct to CBT, fl uoxetine enhances cessation by selectively benefiting medication-compliant smokers who display even subclinical levels of depression.