Early emotional disturbances during nicotine patch therapy in subjects with and without a history of depression

Background: The goal of this study was to compare development of emotional symptomatology during smoking cessation with transdermal nicotine patches in subjects with and without a history of depression. Methods: Twenty-five subjects, 14 with a history of depression and 11 without such a history, were evaluated before beginning of cessation, on day 8, day 30, day 90 and day 120. Results and discussion: On day 120, ten subjects have maintained abstinence: 71.4% of subjects with and 45.5% of subjects without a history of depression relapsed. Both groups presented variable emotional symptomatology and there was no significant differences between subjects with and without a past depression. On the other hand, none of the symptoms which emerged during cessation predicted the issue of cessation. However, some symptoms appearing before beginning of cessation were related to subsequent relapse: lack of pleasure seeking and tiredness. Subsequent relapsers also tended to be more tense on baseline. These early symptoms can not be considered as withdrawal symptoms, they may reflect less confidence in success. It is also suggested that development of anhedonia represents an adaptative strategy to prepare for the withdrawal suffering.