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Green and white capsule nortriptyline dan 10 mg /kg (5 times) in healthy volunteers was effective. [21] Cessation of smoking was achieved by taking two additional tablets once a day, while daily total of ten cigarettes was still smoked every day, and this was kept up throughout smoking cessation treatment. was monitored throughout treatment the two year study and showed complete cessation before the end of trial. dose medication prescribed was based on a single-blind placebo controlled clinical trial of the drug in healthy adult smokers. It was found to effectively lower cigarette consumption in this study, as was demonstrated by the reduction of more than 30% and 70% by the sixth ninth week of treatment and the fourth eighth week of follow-up, respectively. [22, 23] Dextromethorphan and p-chlorophenylalanine (PCPA) This combination of medications inhibits the dopamine transporter and reduces release, [24, 25] producing a sedative effect and reducing motor activity. This effect is also observed if PCPA given in combination with other central dopaminergic medications [14, 25]. One human trial showed that the combination led to a reduction of tobacco smoking by 51%. [26–28] The use of combination was first reported by an RCT in which a reduction smoking cessation from 38% to 24% was observed, in part by the combination of p-chlorophenylalanine with dexchlorpheniramine [29]. Additional trials reported no differences in smoking cessation between the two groups [28, 29]. Another double-blind RCT showed that the combination was less effective when compared with oral p-chlorophenylalanine alone. [30]. Studies in humans have shown similar efficacy of combination treatments, but these include doses as high 30 mg/kg and even 50 mg/kg, respectively ( ). Open in a separate window single oral dose of p-chlorophenylalanine in humans either dose above was found to reduce nicotine craving significantly when compared with one that did not contain the combination agent [31]. In same double-blind trial, p-chlorophenylalanine combined with p-chlorphenylalanine/nicotine reduced the consumption of cigarettes to such a degree that reduction of nearly 25% was seen when p-chlorophenylalanine alone used. [32] Further double-blind trials in healthy controls of higher doses p-chlorophenylalanine with other agents, such as p-chlorophenylalanine with phentermine, methedrone or phenoxybenzamine, were also found to reduce smokers' desire and smoke, as well the duration of smoking abstinence in the treatment groups. this double-blind trial, the combination reduced smoking initiation from 13.43% to 8% and also showed significant reductions in cigarette consumption and total number of cigarettes smoked daily.[3] A more recent double-blind and placebo controlled study found that p-chlorophenylalanine with nornicotine significantly reduced smokers' urge to smoke cigarettes in comparison nicotine alone. [33] An even more extensive study of the potential for combination treatments to reduce tobacco smoking in humans found efficacy for both the p-chlorophenylalanine and nicotine combo, with the combination providing significant reductions in both smoking rates and days abstinent from smoking during their first month and up to five weeks of follow-up. [33] Open in a separate window CNS Depressant Drugs Stimulants such as amphetamines and cocaine cause central nervous system effects that may reduce the incentive to smoke cessation.[34–37] This effect was reported in humans either by combining amphetamines with nicotine, or nicotine mixed amphetamines [38–40] and also in animal studies where nicotine had been combined with cocaine or other stimulants. It was Where to buy phentermine in phoenix az also demonstrated that combining caffeine (0.1 mg/kg), nicotine (1 or d-amphetamine (10 mg/kg) with an alcohol-based solution reduced self-reported cravings for nicotine as well cigarettes [4, 41]. Other human studies, however, revealed that the synergistic effects of nicotine with cocaine on cigarette intake were only observed when cocaine was administered acutely and not when cocaine was given in combination with either nicotine or caffeine. [42–44] An interesting study of combinations cocaine and heroin demonstrated that in combination with heroin reduced desire to smoke, although other studies have not shown a significant effect of cocaine plus heroin. [45] A subsequent double-blind RCT in healthy adult smokers found the combination to be effective in reducing the urge to smoke at a dose of 3 mg/kg cocaine. [43] The combination of cocaine and d-amphetamine (7-10 mg/kg) for six days also reduced the frequency of cigarette withdrawal symptoms in subjects who had quit smoking within the first six days [46]. combination of cocaine (1 mg/kg), methamphetamine (12 mg/kg) and dextroamphetamine)

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