Drugs that mimic endogenous peptides in the brain and periphery by binding to opioid receptors in peripheral afferent nerves, the dorsal horn, and the supra-spinal column.

They inhibit cAMP production, inhibit Ca++ channels, and activate K channels to decrease spontaneous firing, decrease evoked firing, and inhibit transmitter release of pain afferents.

Cheap prototype high-efficacy opioid analgesia that has many routes of administration

First line opioid analgesic

Analgesia - increased pain threshold, increased pain tolerance, anti-tussive, anti-diarrheal, delayed gastric emptying, mood enhancement, relief from pulmonary edema

CONTRAINDICATED: head injuries, pregnancy, asthma, COPD, renal function, hepatic function, Addison's disease, hypothyroidism, hx of substance abuse

Drug Interactions: MAOIs, sedative-hypnotics, and anti-psychotics

Adverse Effects: constipation, N/V, sedation, miosis, tolerance, itch, respiratory depression, decreased medullary response to PCO2, dysphoria, urinary retention, truncal ridigity, physical dependence, addiction

A short term, high efficacy opioid analgesia, used for < 48 hours

Used as a second line agent

Produces a toxic metabolite, normeperidine, that causes CNS stimulation and convulsions, especially in chronic dosing and oral administration

Has greater toxicity than morphine and lower potency and duration than morphine

A pro-drug, high efficacy opioid analgesic that is converted to morphine

Rapidly crosses the BBB

Has a high abuse potential and does not have any medical use in the US

A very short acting, high efficacy opioid analgesic that is used in anesthesia

Available in oral lozenge, transdermal, and lollipop form

A low-medium efficacy opioid analgesic that is combined with acetaminophen

Effects: inhibition of cough at low doses, analgesia at high doses

Only available in oral administration

Adverse effects: histamine release, pruritis

Partially metabolized to morphine

Codeine resistance exists

A low-medium efficacy opioid analgesic that is combined with acetaminophen.

Effects: inhibition of cough at low doses, analgesia at high doses

Only available orally.

Easier to overdose on this drug when compared to other combination opioid/acetaminophen drugs

Highest efficacy in thise category

Metabolized to oxymorphone

Available in slow release prep

"Hillbilly heroin"

A low-medium efficacy opioid analgesic that is combined with acetaminophen

Effects: inhibition of cough at low doses, analgesia at high doses

Only oral administration

Exhibits a very high toxicity with a low efficacy

Cardiotoxicity, CNS toxicity

Black box warning

A mixed agonist/antagonist opioid analgesic that exhibits low dependence

Works as an agonist at the Kappa receptors and an antagonist at the Mu receptors

Combined with acetaminophen

Side effects: dysphoria, hallucinations (kappa), precipitates withdrawal in patients who are on full agonists (mu)

Overdose toxicity is less common

An opioid competitive antagonist at all opioid receptors (but not DM receptor)

Inhibits the effects of endogenous and exogenous endorphins

Uses: reverse effects of opioid overdose, induce withdrawal in rehab

Can only be given parenterally

Rapid acting and short duration

A non-analgesic opioid that is active at the CM receptor, but inactive at opioid receptors

Used as an anti-tussive in cough medicine

There is some abuse potential at due to glutamate and NMDA receptor effects

Synthetic isomer of morphine

A non-analgesic opioid that works on the DM receptor to delay gastric emptying, increase transit time, and increase water reabsorption

Used as an anti-diarrheal

There is very little BBB penetration so there is very little abuse potential

May be useful in neuropathic pain

A sedative-hypnotic that is rapidly and completely absorbed and distributes evenly throughout the body

Exhibits zero order kinetics

Effects: sedation, loss of inhibition, impaired judgement, slurred speech, ataxia, depressed cardiac function, CNS effect, relaxes vascular smooth muscle, hypothermia, relaxes uterine smooth muscle

Adverse effects: additive CNS effects with TCAs

Acetaldehyde causes N/V, HA, and hypotension

MEOS interactions with barbiturates

Metabolized by alcohol dehydrogenase (NAD dependent) into acetaldehyde.

Acetaldehyde is metabolized by acetaldehyde dehydrogenase into acetic acid

Wood alcohol that is metabolized into formaldehyde

Effects: visual dysfunctions, GI stress, SOB, loss of consciousness, and coma

Can cause severe acidosis, retinal damage, and blindness

You can reverse toxicity with ethanol or Fomepizole

Antifreeze

Metabolized into oxalic acid

Effects: severe acidosis, renal damage, formation of oxylate crystals in the urine

Toxicity can be reversed with ethanol or Fomepizole

An opioid antagonist that reduces the effects of endogeous opioid peptides in the brain

Reduces craving for alcohol via the reward pathways

Used to treat alcoholism

Can induce severe withdrawal in patients also addicted/dependent on opioids

Blocks acetaldehyde dehydrogenase conversion of acetaldehyde to acetate

Causes an accumulation of acetaldehyde, which produces unwanted effects when consumed with alcohol - nausea, HA, flushing, and hypotension

Used to treat alcoholism

Adverse effects: respiratory depression, cardiovascular collapse, MI, convulsions, unconsciousness, and sudden death

A PDE5 inhibitor that prevent cGMP from reforming back into GMP to enhance smooth muscle relaxation

Used in erectile dysfunction

Reaches peak plasma levels in 1 hour and has a 4 hour half life

High efficacy

Lower efficacy in diabetic neuropathy and prostatectomy

Adverse effects: hypotension, HA, flushing, indigestion, visual disturbances, nasal congestion, diarrhea, rash, and sudden hearing loss

Nonarteritic Ischemic Optic Neuropathy can develop after continual use

Drug Interactions: nitrates

Most commonly used drug for ED before Sildenafil

Relaxes smooth muscle in the corpora cavernosa

Adverse effects: hypotension, mild penile pain, and priapism

Injectible or urethral suppository

A barbiturate that binds to GABAa receptors to enhance duration of GABA-mediated Cl- influx

It also directly opens Cl- channels, suppresses glutamate transmission, and has direct effects on the membrane --> dirty drug!

Causes sedation, hypnosis, coma, anesthesia, amnesia, and respiratory depression

Used as a sedative-hypnotic, anesthesia, and in seizure disorders

Adverse effects: dependence, addiction, and drug interactions

Has a low therapeutic index

A full benzodiazepine agonist that binds to all BZ receptors to enhance GABA channel opening and Cl- influx

Rapidly absorbed, 10-24 hours half life

Converted to active metabolites

Causes CNS sedation, disinhibition, hypnosis, amnesia, anesthesia at high doses, anticonvulsant, skeletal muscle relaxatin, modest respiratory inhibition, and some cardiac inhibition

Uses: GAD, situational anxiety, sleep disorders, epilepsy, anesthesia, alcohol dependence withdrawal, and muscle relaxation

Exhibits tolerance and cross-tolerance with other sedative-hypnotics

Development of psychological dependence

Physical dependence can cause anxiety, insomnia, irritability, CNS excitability, and seizures

A full benzodiazepine receptor agonist that binds to all BZ receptors to enhance GABA channel opening and Cl- influx

Slower acting, 10-24 hour half life

Causes CNS sedation, disinhibition, hypnosis, amnesia, anesthesia at high doses, anticonvulsant, skeletal muscle relaxatin, modest respiratory inhibition, and some cardiac inhibition

Uses: GAD, situational anxiety, sleep disorders, epilepsy, anesthesia, alcohol dependence withdrawal, and muscle relaxation

Exhibits tolerance and cross-tolerance with other sedative-hypnotics

Development of psychological dependence

Physical dependence can cause anxiety, insomnia, irritability, CNS excitability, and seizures

A full benzodiazepine receptor agonist that binds to all BZ receptors to enhance GABA channel opening and Cl- influx

2-3 hour half life (greater risk of withdrawal with shorter acting drugs)

Causes CNS sedation, disinhibition, hypnosis, amnesia, anesthesia at high doses, anticonvulsant, skeletal muscle relaxatin, modest respiratory inhibition, and some cardiac inhibition

Uses: GAD, situational anxiety, sleep disorders, epilepsy, anesthesia, alcohol dependence withdrawal, and muscle relaxation

Exhibits tolerance and cross-tolerance with other sedative-hypnotics

Development of psychological dependence

Physical dependence can cause anxiety, insomnia, irritability, CNS excitability, and seizures

A full benzodiazepine receptor agonist that binds to all BZ receptors to enhance GABA channel opening and Cl- influx

Causes CNS sedation, disinhibition, hypnosis, amnesia, anesthesia at high doses, anticonvulsant, skeletal muscle relaxatin, modest respiratory inhibition, and some cardiac inhibition

Uses: GAD, situational anxiety, sleep disorders, epilepsy, anesthesia, alcohol dependence withdrawal, muscle relaxation, panic disorders, and agoraphobia

Exhibits tolerance and cross-tolerance with other sedative-hypnotics

Development of psychological dependence

Physical dependence can cause anxiety, insomnia, irritability, CNS excitability, and seizures

A full benzodiazepine receptor competitive antagonist that works at the BZ binding site on the GABAa receptor

Reverses the effects of BZ and hypnotics

Uses: BZ overdose, hasten recovery after use in surgery

Adverse effects: agitation, confusion, dizziness, nausea

Rapid acting with 1 hour half life

A non-sedative anxiolytic that is a partial agonist at the CNS 5-HT1a receptor

Reduces anxiety via serotonin pathways
Rapidly absorbed, first pass metabolism

Converted to active metabolites

Half life: 2-3 hours

Uses: GAD, depression

Adverse effects: nonspecific chest pain, tachycardia, palpitations, dizziness, nervousness, tinnitus, GI problems

Drug interactions: MAOIs

Has no sedative, hypnotic, anti-seizure, or euphoric effects

A melatonin receptor agonist (at MT1 and MT2 receptors) given as OTC sleep aid

Used for long term insomnia, and is best against delayed onset sleep and circadian rhythm problems

Adverse effects: dizziness, hyperprolactinemia, and decreases in testosterone

Has no effect on GABA receptors or sleep patterns

Benzodiazepine receptor agonists that bind selectively to BZ receptor with the alpha 1 subunit

A hypnotic used for sleep disorders

Available in a sustained release

Adverse effects: retrograde amnesia, sleep walking

Effects are reversed by flumazenil

A benzodiazepine receptor agonist that binds selectively to the BZ receptor with an alpha 1 subunit

A hypnotic used in sleep disorders

Exhibits less amnesia and day-after sedation

Effects are reversed by flumazenil

Precursor for DA synthesis that crosses the BBB and is converted to dopamine

Used in Parkinson's disease to restore DA in the striatum

Central adverse effects: sexual inappropriateness, dyskinesia

Peripheral adverse effects: nausea, palpitations, orthostatic hypotension

Some is converted to DA and 3-O-MD in the periphery and is the cause of some side effects

Exhibits on-off phenomenon

CONTRAINDICATIONS: melanoma, psychosis, narrow angle glaucoma

Drug interactions: non-selective MAOI, vitamin B6

Inhibition of the enzyme L-AAD that converts L-DOPA into DA in the periphery

Allows more delivery of L-DOPA to the CNS

Slows metabolism of L-DOPA in the CNS

Used as adjunct therapy to L-DOPA to reduce dose of L-DOPA and reduce peripheral side effects

Has a risk of increased CNS toxicity

Given in combination pill

Inhibits central and peripheral L-DOPA metabolism by COMT to increase the effets of L-DOPA in the CNS and decrease peripheral side effects

Used as adjunct therapy in Parkinsons disease

Inhibits metabolism of DA by MAO-B in the CNS to increase the effets of DA and reduce the on-off phenomenon

Used as adjunct to L-DOPA in Parkinson's disease

Available in a patch or combination pill

Direct agonist at CNS D2 receptors to stimulate the D2 receptor and reduce the on-off phenomenon

Used as adjunct to L-DOPA in Parkinson's disease

Adverse Effects: Nausea, hypotension, dyskinesia, and psychosis

The risk of dyskinesia is lower than with L-DOPA, but the risk of psychosis is higher

Blocks ACh activation of GABAergic efferents to restore the DA-ACh balance on the GABA neuron in the striatum

Used as an adjunct to L-DOPA in Parkinson's disease or used in mild Parkinsons (effective against just tremor)

Adverse effects: Anticholinergic side effects

Has a high penetrance to the brain

Low potency neuroleptic that blocks D2 receptors (and others)

Decreases DA in the mesocorticolimbic system, acute sedation, slowed response to stimulu, and reduced inhibitions, decrease in agitation and aggression, and less withdrawal, a decrease in positive symptoms, and a decrease in disorganized thinking

Used in schizophrenia, psychosis, bipolar maintenance, Tourette's

Adverse effects: mostly extrapyramidal effects - dystonia, akinesia, akasthisia, tardive dyskinesia

Adverse effects due to alpha 1 block: reflex tachycardia, orthostatic hypotension, and inhibited orgasm

Adverse effects due to anticholinergic: dry mouth, blurred vision, constipation, urinary retention, memory impairment, confusion, impotence

Can also cause sedation, weight gain, and DM

Neuroleptic Malignant Syndrome: dangerous muscle rigidity, very high fever, autonomic instability, myoglobinuria

Treat with bromocriptine and BZs

Higher potency neuroleptic that blocks D2 receptors (and others to a lesser extent - extra side effects are less common)

Decreases DA in the mesocorticolimbic system, acute sedation, slowed response to stimulu, and reduced inhibitions, decrease in agitation and aggression, and less withdrawal, a decrease in positive symptoms, and a decrease in disorganized thinking

Used in schizophrenia, psychosis, bipolar maintenance, Tourette's

Adverse effects: mostly extrapyramidal effects - dystonia, akinesia, akasthisia, tardive dyskinesia

Adverse effects due to alpha 1 block: reflex tachycardia, orthostatic hypotension, and inhibited orgasm

Adverse effects due to anticholinergic: dry mouth, blurred vision, constipation, urinary retention, memory impairment, confusion, impotence

Can also cause sedation, weight gain, and DM

Neuroleptic Malignant Syndrome: dangerous muscle rigidity, very high fever, autonomic instability, myoglobinuria

Treat with bromocriptine and BZs

Blocks D1, D2, and D4 receptors

Blocks H-HT2 and Alpha 1 receptors

An atypical drug used in schizophrenia and psychosis and has better efficacy against negative and cognitive symptoms

Adverse effects: agranulocytosis - very limiting!

Lower incidence of tardive dyskinesia, but a higher incidence of DM and metabolic symptoms

Higher potency atypical drug that blocks D2 receptor

Used in schizophrenia and psychosis and has a better efficacy with negative and cognitive symptoms

An atypical partial D2 receptor agonist used in schizophrenia, bipolar disorder, and as an adjunct to depression meds

Has a better efficacy on negative and cognitive symptoms

An SSRI that blocks the SERT

Increases the level of 5-HT at the synapse

Initial effects: GI upset, CNS stimulation, and restlessness

After 2-6 weeks: improvement of depressive symptoms

Used in depression, anxiety, eating disorders, PMDD, ADD/ADHD, and other off-label uses

Oxidized by CYP3A4, so many drug interactions

Produces active metabolite norfluoxetine

Half life: 24 hours

Tolerance to side effects usually develops, but there is no tolerance to sexual dysfunction

Adverse effects: CNS stimulation, insomnia, agitation, anxiety, decreased libido, anorgasmia, GI bleeding, nausea, akathisia

Serotonin Syndrome occurs when combined with MAOIs and other ADDs, stimulants, St. John's work

Symptoms include extreme hyperthermia, acidosis, shock, muscle rigidity, seizures, and renal failure

Treat serotonin syndrome with 5-HT antagonist

An SSRI that blocks the SERT

Increases the level of 5-HT at the synapse

Initial effects: GI upset, CNS stimulation, and restlessness

After 2-6 weeks: improvement of depressive symptoms

Used in depression, anxiety, eating disorders, PMDD, ADD/ADHD, and other off-label uses

Exhibits more frequent sexual side effets and weight gain

Cannot be used in pregnancy

Shorter acting

Tolerance to side effects usually develops, but there is no tolerance to sexual dysfunction

Adverse effects: CNS stimulation, insomnia, agitation, anxiety, decreased libido, anorgasmia, GI bleeding, nausea, akathisia

Serotonin Syndrome occurs when combined with MAOIs and other ADDs, stimulants, St. John's work

Symptoms include extreme hyperthermia, acidosis, shock, muscle rigidity, seizures, and renal failure

Treat serotonin syndrome with 5-HT antagonist

An SSRI/SNRI that blocks the SERT and the NET at higher doses

Increases the level of 5-HT at the synapse

Initial effects: GI upset, CNS stimulation, and restlessness

After 2-6 weeks: improvement of depressive symptoms

Used in depression, anxiety, eating disorders, PMDD, ADD/ADHD, and neuropathic pain

Half life: 8-15 hours

Tolerance to side effects usually develops, but there is no tolerance to sexual dysfunction

Adverse effects: Increased BP at high doses, CNS stimulation, insomnia, agitation, anxiety, decreased libido, anorgasmia, GI bleeding, nausea, akathisia

Serotonin Syndrome occurs when combined with MAOIs and other ADDs, stimulants, St. John's work

Symptoms include extreme hyperthermia, acidosis, shock, muscle rigidity, seizures, and renal failure

Treat serotonin syndrome with 5-HT antagonist

A newer anti-depressant medication that blocks the reuptake of DA through the DAT

Also blocks the NET and SERT

Increases DA and NE in the CNS

Used in adjunct in depression therapy with SSRIs to reduce sexual side effects

Also used in smoking cessation

Adverse effects: CNS stimulation, HA, anxiety, and seizures

Has the lowest incidence of side effects among ADDs but has a lower overall response rate

A newer anti-depressant medication that blocks the 5-HT1a feedback inhibitor of serotonin

Blocks alpha 2, alpha 1 receptors

Blocks 5-HT2, 5-HT3, and H1 receptor

Increases synaptic serotonin and NE used for depression

Adverse effects; Sedation, increased appetite, weight gain, dry mouth, and orthostatic hypotension

This is a dirty drug

A newer anti-depressant that is a 5-HT receptor antagonist

No other information given

TCA (tertiary amine) that preferentially blocks the SERT and NERT

Also blocks muscarinic, alpha 1, and H1 receptors

Tertiary amines are metabolized to secondary amines in the blood

Has a low therapeutic index

Causes an increase in serotonin and NE in the synapse

Initial effects: drowsiness, dry mouth, constipation, anxiety, dysphoria, and difficulty concentrating

At 2-6 weeks: gradual decrease in depressive sx

Used in depression, anxiety, enuresis, neuropathic pain, and migraine pain

Anticholinergic side effects: dry mouth, tachycardia, urinary retention, cognitive impairment

Alpha 1 Block side effects: orthostatic hypotension, sexual side effects

H1 Blocks side effects: weight gain, sedation

Overdose toxicity: confusion, hallucination, respiratory depression, and death by arrhythmias

TCA (secondary amine) that preferentially blocks the NET

Also blocks muscarinic, alpha 1, and H1 receptors

Tertiary amines are metabolized to secondary amines in the blood

Has lower incidence of side effects

Causes an increase in serotonin and NE in the synapse

Initial effects: drowsiness, dry mouth, constipation, anxiety, dysphoria, and difficulty concentrating

At 2-6 weeks: gradual decrease in depressive sx

Used in depression, anxiety, enuresis, neuropathic pain, and migraine pain

Anticholinergic side effects: dry mouth, tachycardia, urinary retention, cognitive impairment

Alpha 1 Block side effects: orthostatic hypotension, sexual side effects

H1 Blocks side effects: weight gain, sedation

Overdose toxicity: confusion, hallucination, respiratory depression, and death by arrhythmias

An MAOI that irreversibly inhibits MAO, mostly unselectively

Inhibition occurs in brain and periphery

Causes increased NE and serotonin in nerve terminals

Behavioral effects: acute CNS stimulation, agitation, euphoria, appetite suppression, and overall improvement in depressive sx

This is a 3rd line drug for depression

Very effective against atypical depression

Adverse effects: CNS stimulation, orthostatic hypotension, GI distress, and sexual dysfunction

Drug interactions: sympathomimetics, SSRIs, SNRIs, TCAs, trazadone, nefazadone, meperidine

Interacts with tyramine in food and wine

First line bipolar drug that mediates mood swings

Used for bipolar maintenance, depression, and schizoaffective disorder

Gradual response, orally absorbed

Half life: 20-24 hours - must monitor levels

Adverse effects: tremor, sedation, fatigue, GI problems, edema due to increased aldosterone, mily hypothyroidism, nephron inflammation, loss of ADH effectiveness, polydipsia, polyuria, acne, psoriasis

Drug interactions: increased Na causes decreased excretion and development of toxic levels

Toxicity: OD can occur in normal therapy - confusion, ataxia, hypotension, arrhythmias, convulsions, and coma

An anti-convulsant used in bipolar disorder acute mania and maintenance

Adverse effects: GI side effects, weight gain, alopecia

Has a high therapeutic index

Safe to use in emergencies

An anti-convulsant that is used in bipolar disorder in acute mania and maintenance

Also useful in Bipolar II

Adverse effects: nausea, dizziness, headache, serious rash

Schedule II stimulant that binds to nicotininc receptors

Causes calming effects, decreased anxiety, stimulation, arousal, increased concentration, and loss of appetite

Used in smoking cessation therapy and neurologic disease (Parkinson's, Alzheimer's, and Tourette's)

Withdrawal symptoms: HA, irritability, tremor

Schedule II stimulant that blocks the reuptake of DA (and NE and 5-HT to a lesser extent)

Can be in soluble form or insoluble form (crack)

NE causes: arousal, alertness, insomnia

DA causes: euphoria, increased confidence, flow of ideas, talkativeness

Increased temperature, respiration, libido, decreased hunger and thirst, increased HR, BP, sweating, nausea, cramps, HA, muscle twitching, teeth grinding

Used in ADHD

Withdrawal effects: lethargy, hunger, depression, continued wakefulness, profound anorexia, hyperactivity, hyperirritability, labile mood, violent behavoir, hallucinations, psyhcosis

OD: arrhythmias, MI, stroke

Exhibits profound psychological dependence, though lesser physical dependence

Crack can be more addictive!

Schedule II stimulant that enhances release of DA and NE

NE causes: arousal, alertness, insomnia

DA causes: euphoria, increased confidence, flow of ideas, talkativeness

Increased temperature, respiration, libido, decreased hunger and thirst, increased HR, BP, sweating, nausea, cramps, HA, muscle twitching, teeth grinding

Used in ADHD

Withdrawal effects: lethargy, hunger, depression, continued wakefulness, profound anorexia, hyperactivity, hyperirritability, labile mood, violent behavoir, hallucinations, psyhcosis

OD: arrhythmias, MI, stroke

Exhibits profound psychological dependence, though lesser physical dependence

Schedule II stimulant

Amphetamine that has slightly more CNS effects than amphetamines

Insoluble form of amphetamine

Less peripheral effects

Longer lasting

Schedule I psychedelic that is serotonin related

Has sympathomimetic effects - flushing, dry mouth, tachycardia, altered perceptions, visual hallucinations, labile mood, altered thought

Little tolerance or dependence seen

Effects are highly dependence on expectations and settings

Schedule I deliriant that inhibits NMDA glutamate receptor

Usually smoked, oral, IV, nasal

Has sympathomimetic effects - flushing, dry mouth, tachycardia, altered perceptions, visual hallucinations, labile mood, altered thought

Peripheral effects: Increased HR, BP, salivation, muscle rigidity, ataxia, increased strength, blank stare, nystagmus, loss of sensation

CNS effects: amnesia, repetitive purposeless movements, coma, death

Acute adverse effects: pychosis, seizure, coma, death, arrhythmias, myoglobinuria, renal failure, accidents, violence

Chronic adverse effects: psychosis, mood and personality disorders, impaired memory, intellectual performance, and speech disorders

Schedule I depressant that acts at cannabinoid receptors (THC is main ingredient)

Effects: depressant, psychedelic, sympathomimetic

Uses: appetite stimulant, anti-nausea, anti-seizure, and glaucoma

Little evidence for tolerance, though it depends on set and setting

No physical dependence is developed

Psychological dependence can occur with variability

Performance enhancer that stimulates the secretion of GH

Increases muscle bulk, reduces fat, and sedation

Partial agonist at mu receptor that blocks effects of other opioid agonists

Used in opioid addiction

Difficult to overdose

Milder withdrawal

Levo-alpha-acetyl methadyl, a long acting opioid that is used to treat opioid addiction

Taken 2-3x per week

An opioid that has slightly different kinetics than heroin

Satiates opioid cravings without sharp peaks and valleys

Used for opioid detox and maintenance

Can be used long term without significant impairment

Oral dosing

Withdrawal is longer but less intense

Long acting mu receptor antagonist

Used in opioid addiction and alcoholism

Has limited success but has shown good results with alcoholism

Anti-depressant that is helpful in smoking cessation

Reduces desire to smoke

Can be used with NRT

Black box warning

Partial agonist at Alpha4Beta2 CNS nicotinic receptor

Reduces the desire to smoke

Adverse effects: HA, sleep and dream disturbances, anxiety, changes in behavior, suicidal ideation

Black box warning