The antidepressants are very commonly used in the complex therapy of tobacco dependence.

As the model of antidepressant drug the pyrazidol was chosen as having the verified effect on serotonin, dofamin, noradrenalin receptors.

113 tobacco dependent patients with primary (45) and secondary (67) resistance to nicotine replacement therapy (NRT) were involved in double-blind placebo controlled study.

Pyrasidol was given in small therapeutic dosages (100 – 150 mg for a day) in combination with NRT ore varenicline to cure smoke cessation in the course of 6 weeks.

The Assessment Scale for Tobacco Dependence Symptoms Level and Hamilton Depressive Scale were used in longitude dynamic study.

For the patients with primary NRT resistance the result was double regress of somato-vegetative and neurotic symptoms of tobacco craving (from 4 balls to 2,1±0,03 balls). It accompanied by more then 2 times smoking reduction (from 35,5 to 12,3 cigarettes per day).

The results for the secondary resistant NRT resistant were much better. The total regress of tobacco craving symptoms included somatovegetative, neurotic and ideatory signs (from 4 balls each item to 1 – 0,5 balls). All the patients after 6 weeks of treatment stopped smoking.

The reduction of smoking was strongly associated with total regress of comorbid affective disorders in both groups.

The effect of complex therapy for the patients with primary resistance was not so significant as for the secondary resistant ones. So they needed more complicated treatment, including non – medicated approaches – bio-feed-back, hypoxia therapy and so on.</h4>