ニコチン置換療法とparoxetine併用が有効であったニコチン依存症の1症例

A Case of Nicotine Dependence Syndrome Responding to the Nicotine Replacement Therapy Used Together with Paroxetine

【抄録】　従来型の禁煙方法やニコチン置換療法で禁煙に失敗したが，ニコチン置換療法にparoxetineを併用して長期の禁煙に成功したニコチン依存症例を経験したので報告する。症例は42歳，男性。禁煙成功の理由として，paroxetineがニコチン依存症に対して直接的に作用したのか，もしくは退薬症状に奏効したことでニコチン置換療法を円滑に進めることができたのか検討が必要である。しかし本研究からparoxetineはニコチン依存症，もしくはその退薬症状に有効であること，また禁煙継続における精神的安定の保持にも有効であることが示唆された。よって，SSRIの臨床適応にニコチン依存症も含まれる可能性が考えられた。

　We reported the case of a 42-year-old man with nicotine dependence syndrome. The usual way of prohibiting smoking, but using nicotine replacement therapy was unsuccessful in this case. When we tried nicotine replacement therapy used together with paroxetine, tobacco withdrawal symptoms disappeared and the patient succeeded in giving up smoking for nine months. Because of this, we supposed that paroxetine had either a direct efficacy against nicotine dependence syndrome, or had the effect of easing withdrawal symptoms so that the nicotine replacement therapy was able to take effect smoothly.

　The reasons for success in this case are still not clear, but this study showed that paroxetine was a contributing factor to the improvement of nicotine replacement therapy and helped to maintain the patient's mental stability for the duration of the period of treatment. We suggests that nicotine dependence syndrome is included in the clinical properties of SSRI.