Tobacco Use Disorder Clinical Trial
Official title:
Smoking, Antidepressants, and Response to Mental Stress
Smokers report that they often smoke cigarettes during stressful times. The combined effect of smoking and exposure to stress leads to exaggerated increases in blood pressure, heart rate and other measures of stress response. This combination may result in greater cardiovascular harm than either smoking or stress alone. The purpose of this study is to determine the effects of paroxetine on the response to stress after smoking.
Smokers report that they often smoke cigarettes during stressful times. Smoking and stress
produce similar physiological responses such as increases in heart rate, blood pressure, and
adrenaline levels. The combination of smoking and stress results in greater increases in
these physiological responses compared to smoking or stress alone. Such increases are thought
to be harmful to cardiovascular health. Additionally, smokers with exaggerated responses to
stress may be more likely to relapse following a smoking cessation attempt. The purpose of
this study is to assess the effects of paroxetine, a selective serotonin reuptake inhibitor
(SSRI), on the cardiovascular response to stress after smoking.
Participants in this double-blind, placebo-controlled study will receive 1 month of
paroxetine and 1 month of placebo with the order of which is taken during the first month
randomly assigned. Paroxetine will be administered at a daily dose of 10 mg for the first
week and increased to a daily dose of 20 mg for the remainder of the study. After one month
of medication, participants will abstain from smoking for one night and then undergo mental
stress testing the following day. Immediately prior to the mental stress testing,
participants will smoke a cigarette. Mental stressors will include speaking and math tasks.
Physiological measures of stress (e.g., blood pressure, heart rate, and plasma catecholamine
concentrations) and subjective measures of stress will be evaluated. Following the second
month of medication, participants will again undergo the procedure for mental stress testing
and evaluation.
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