21 points. The difference between treatment groups was not statistically significant (t test, p = .65). Discussion Though two trials using oral selegiline showed trends toward improved abstinence, the recent trial by Weinberger did not. Since smokers smoke throughout the selleck chemicals llc day, we postulated that transdermal delivery of selegiline would be advantageous over oral delivery because it provides a higher more consistent blood level of selegiline over 24 hr. However, the present study did not demonstrate that STS with BRBI improved quit rate during 9 weeks of treatment. Our study most closely resembles the clinical trial conducted by Killen et al. (2010) of 243 smokers randomized between STS and placebo for 8 weeks, which failed to demonstrate a difference between the treatment groups followed out to 52 weeks.

Overall, STS was well tolerated with comparable rates of compliance between treatment groups. Subjects in both groups were retained in the study at a similar rate. No effect on HAM-D scores was observed; however, only smokers with mild-to-moderate baseline HAM-D scores were included. Although we found no differences between groups in mean ratings of withdrawal symptoms in the intent-to-treat population, in the subgroup of successful quitters, some symptoms of withdrawal appeared to be alleviated more successfully by STS. Although the metabolism of selegiline is a disadvantage in the treatment of Parkinson��s disease, this may not be the case for addictions. The levo-isomers of amphetamine and methamphetamine have both cardiovascular and psychological effects, though somewhat attenuated in comparison with the dextro-isomers.

Mendelson et al. (2006) demonstrated that l-methamphetamine had cardiovascular and psychoactive effects at higher doses than d-methamphetamine and dissipated sooner than the equipotent dose of d-methamphetamine. Possibly, the stimulative effects of the active metabolites are needed for the success of selegiline for drug abuse indications in general as has been suggested previously (Elkashef et al., 2006). Molecular imaging studies have demonstrated that smokers during early abstinence have a larger than a normal population of unoccupied beta-2 acetylcholine receptors in the cortex and cerebellum, which does not begin to normalize until six or more weeks after smoking cessation (Staley et al., 2006).

Availability of unoccupied cerebellar beta-2 acetylcholine receptors at 4 weeks has been correlated with craving (Cosgrove et Dacomitinib al., 2009). Neither selegiline nor its metabolites interact with acetylcholine receptors, providing a reason why NRT combined with oral selegiline treatment was more successful than NRT alone in the one study that addressed this comparison (Biberman et al., 2003). However, STS alone at the standard therapeutic dose is unlikely to represent an effective treatment for smoking cessation for most smokers.