Article type
Abstract
Objective: To evaluate the effectiveness, safety, and tolerability of antidepressants in helping smokers to quit tobacco dependence.
Methods: Five databases were searched for randomized controlled trials (RCTS) of different antidepressant interventions involving smoking cessation in populations (September 2022). STATA 15.1 software was used to perform network meta-analysis. The Cochrane bias risk tool was used to assess the risk of bias, and CINeMA was used to evaluate the evidence credibility of the effect of different interventions on smoking cessation.
Results: A total of 107 randomized controlled trials involving 42,744 patients were included. Five studies were rated as having a low risk of bias. All trials reported 18 interventions and a total of 153 pairwise comparisons were generated. The network meta-analysis showed that, compared with placebo, the benefits of smoking cessation were found in Varenicline + Bupropion (OR = 3.53, 95%CI [2.34, 5.34]), Selegiline + Nicotine replacement therapy (NRT) (OR = 3.78,95% CI [1.20, 11.92]), Nortriptyline + NRT (OR = 2.33, 95% CI [1.21, 4.47), Nortriptyline (OR = 1.58, 95% CI [1.11,2.26]), Naltrexone + Bupropion (OR = 3.84, 95%CI [1.39, 10.61]), Bupropion + NRT (OR = 2.29,95% CI [1.87, 2.81]), Bupropion (OR = 1.70, 95% CI [1.53, 1.89]). In addition, Bupropion + NRT was better than Bupropion (OR = 1.35, 95%CI [1.12, 1.64]) and NRT (OR = 1.38, 95%CI [1.13, 1.69]) respectively. The final cumulative ranking curve showed that Varenicline + Bupropion was the most likely to be the best intervention.
Conclusions: There was moderate to very low-certainty evidence that most interventions showed benefits for smoking cessation compared with placebo, including monotherapy and combination therapies. In addition, Varenicline + Bupropion had a higher probability of being the best smoking cessation intervention.
Methods: Five databases were searched for randomized controlled trials (RCTS) of different antidepressant interventions involving smoking cessation in populations (September 2022). STATA 15.1 software was used to perform network meta-analysis. The Cochrane bias risk tool was used to assess the risk of bias, and CINeMA was used to evaluate the evidence credibility of the effect of different interventions on smoking cessation.
Results: A total of 107 randomized controlled trials involving 42,744 patients were included. Five studies were rated as having a low risk of bias. All trials reported 18 interventions and a total of 153 pairwise comparisons were generated. The network meta-analysis showed that, compared with placebo, the benefits of smoking cessation were found in Varenicline + Bupropion (OR = 3.53, 95%CI [2.34, 5.34]), Selegiline + Nicotine replacement therapy (NRT) (OR = 3.78,95% CI [1.20, 11.92]), Nortriptyline + NRT (OR = 2.33, 95% CI [1.21, 4.47), Nortriptyline (OR = 1.58, 95% CI [1.11,2.26]), Naltrexone + Bupropion (OR = 3.84, 95%CI [1.39, 10.61]), Bupropion + NRT (OR = 2.29,95% CI [1.87, 2.81]), Bupropion (OR = 1.70, 95% CI [1.53, 1.89]). In addition, Bupropion + NRT was better than Bupropion (OR = 1.35, 95%CI [1.12, 1.64]) and NRT (OR = 1.38, 95%CI [1.13, 1.69]) respectively. The final cumulative ranking curve showed that Varenicline + Bupropion was the most likely to be the best intervention.
Conclusions: There was moderate to very low-certainty evidence that most interventions showed benefits for smoking cessation compared with placebo, including monotherapy and combination therapies. In addition, Varenicline + Bupropion had a higher probability of being the best smoking cessation intervention.