Can I Smoke Cigarettes While on Antidepressants?

Cigarette smoking provides a number of calming effects to smokers. One reason behind this is nicotine, which is naturally produced by the tobacco smoke from cigarettes.

Nicotine is a highly addictive substance that can reach your brain as quickly as possible. As the cigarette smoke enters the lungs, its nicotine content is being absorbed. This substance then travels to the brain within seconds, which triggers the release of dopamine and other neurotransmitters that cause a buzz or feeling of pleasure, concentration, and relaxation.

The soothing effects of cigarettes typically entice individuals who might be experiencing stress, anxiety, or even depression. Those who take antidepressants and other similar medications might also want to smoke cigarettes due to their effects. But is it a good move to smoke cigarettes while on antidepressant drug treatment? Find out more here at Native Smokes 4 Less.

Introduction to Antidepressants

If you have depression, you have to take antidepressants to help treat the said mood disorder. Depression is a mood disorder that causes a persistent feeling of sadness as well as a loss of interest in activities and things you once enjoyed fully. It may likewise cause difficulty with thinking, motivation, eating, sleeping, and even memory.

Not all depressive disorders are similar. They come in many types, including clinical depression (major depressive disorder), bipolar depression, persistent depressive disorder (PDD), premenstrual dysphoric disorder (PMDD), atypical depression, and seasonal depression (seasonal affective disorder).

To treat depression, healthcare providers typically prescribe antidepressants. Some particular conditions that antidepressants may be able to treat include clinical depression and other depressive disorders, bipolar disorder, bulimia, generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), and social anxiety disorder (social phobia).

A number of healthcare providers then prescribe these medications for chronic pain, insomnia, and migraine. This type of prescription is typically considered an off-label use of the medication.

The working principles of antidepressants are pretty straightforward.

They typically alter the way your brain uses neurotransmitters to effectively regulate your behaviour and mood. The most common brain chemicals or neurotransmitters that antidepressants often regulate include serotonin, norepinephrine, and dopamine.

Aside from changing the way your brain works, antidepressant treatments can also induce neuroplasticity. It is a process wherein your brain changes its structure by strengthening or weakening connections between neurons or brain cells.

While antidepressants, regardless of their class or type, can treat a number of symptoms of the said mood disorder, these medications might not be able to address its causes. A number of studies show that the effectiveness of antidepressant treatment can often depend on the severity of the depression. In moderate, severe, and chronic depression, antidepressants are typically effective. Those with mild depression, alternatively, might not be able to benefit from antidepressants.

Given this fact, medical professionals often recommend pairing antidepressant treatment with psychotherapy or talk therapy. The combination of these two things can typically produce the largest improvements in depression symptoms.

The Relationship Between Smoking and Depression Pharmacological Treatment

The complex relationship between smoking and depression has significant implications for pharmacological treatment. 

Many adults, especially those who are depressed and taking depression pharmacological treatment, smoke cigarettes as their primary way of coping with the feelings or emotions they are dealing with. Additionally, they believe that smoking can alleviate their depressive symptoms temporarily. They likewise depend on nicotine and its calming effects.

Nicotine, the primary addictive component in tobacco, interacts with brain chemistry in ways that can alleviate depressive symptoms in a short time by stimulating the release of dopamine, serotonin, and norepinephrine. However, this relief is short-lived. So, over time, nicotine dependence can worsen mental health, which contributes to a cyclical pattern of low mood and smoking.

From a pharmacological standpoint, smoking introduces tons of complications in treating depression.

One of the key issues is the way smoking affects the metabolism of antidepressant medications. Cigarette smoke contains substances such as polycyclic aromatic hydrocarbons that induce liver enzymes, particularly cytochrome P450 1A2 (CYP1A2). This enzyme is responsible for metabolizing several antidepressants, including fluvoxamine, duloxetine, mirtazapine, tricyclic antidepressants (TCAs), benzodiazepines, clozapine, and olanzapine.

In individuals who smoke, these types of antidepressants may be broken down more rapidly, which leads to reduced plasma concentrations and reduced therapeutic effects. Healthcare professionals may prescribe higher doses to compensate for the increased metabolic rate. However, it only creates a delicate balancing act. If the patient quits smoking suddenly, the same dosage could result in toxic drug levels, which increase the risk of adverse side effects.

Moreover, smoking reduces the levels of monoamine oxidase (MAO) enzymes in the brain that help break down neurotransmitters. This reduction mimics the effect of a number of antidepressant medications and will only complicate treatment outcomes.

Most antidepressants, after all, could cause side effects that depend on the dose taken. Some side effects could only occur when the levels of the antidepressant in the blood reach a certain point. Since smoking tobacco can decrease the levels of some drugs in the blood, quitting smoking, especially for heavy smokers who take these medications, could increase the intensity of these drugs. This increase might cause side effects that were not present before.

For depression, smoking cessation must be considered a vital component of a comprehensive treatment plan. Quitting smoking, however, could be particularly challenging for those with existing mental health conditions. Withdrawal symptoms like irritability, low mood, and anxiety may only worsen depressive symptoms in the short term.

Nonetheless, research suggests that successful long-term smoking cessation is directly linked with improved mood and reduced symptoms of depression. Therefore, it’s important for a doctor to create a well-structured cessation strategy to account for the mental health status of patients with depression.

When it comes to pharmacological aids for smoking cessation, bupropion is notable for its dual role. It is not only an antidepressant but also approved as a smoking cessation aid. Its dual function makes it particularly suitable for patients dealing with both nicotine dependence and depression.

Another option is varenicline, which has been shown to be effective in promoting smoking cessation. However, there have been concerns about its potential to elevate psychiatric symptoms, although more recent studies indicate that it is safe when properly monitored.

Integrating smoking cessation support with mental health is vital, benefitting patients who find it difficult to quit smoking while dealing with depression or other mental health issues. A coordinated approach that involves general practitioners, psychiatrists, and cessation specialists is then important so they can craft an integrated care model that lets them monitor medication interactions and adjust the dosage, especially if a patient decides to reduce or quit smoking during the course of treatment.

Depression treatment among smokers can be a complex but manageable task, especially when approached with a full understanding of how tobacco smoke affects pharmacological outcomes. Fortunately, they can expect better health outcomes if their medications have been adjusted based on their smoking status and habit if their cessation aids like nicotine replacement therapy tools (NRTs) have been carefully selected, and if they continuously receive psychological support.