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Question
Posted by: Nutty | 2008/09/18

Bipolar and Smoking

I have bipolar mood disorder and I smoke alot. I need to quit smoking. The problem is I always smoke when I get upset, I use aterax for anxiety but a smoke usually works faster. I need to quit smoking because of my health. I asked my docker and he said because i am bipolar I can not use any mood altering medication while quiting smoking eg Ziban. They say quitting smoking is bad for your moods, it cause depression, axiety. I would like to know how I can quit smoking with out it having a very negative effect on my mental health. My bipolar has been stable for about a year now, after struggling for 5 years to stabilise. I really need help and advice.

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Our expert says:
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One of the components of the addictiveness of tobaco smoking is that it can be used to stimulate you, or to help you calm down when agitated. And this needs to be taken into account when managing smoking cessation. I wonder whether the doc you spoke to was a GP or a psychiatrist ? Quitting smoking can cwertainly upset someone's mood temporarily, but usually improves it in the long run. Now, antidepressants like Bupropion ( the active ingredient in DZyban ) are used oin the treatment of Bipolar Disorder in regard to its depressive episodes. Perhaps your doc was thinking, if you are mostly prone to upswings and manic episodes, that Zyban, like any other antidepressant, might precipitate one of those. If he has managed your previous episodes, he might be the best judge or that, and of whether other mood stabilizing meds might avoid or limit that risk, or whether it would be best avoided. Only someone familiar with the treatment and clinical details of your 5 year struggle to gain control over the bipolar problems previiously, could judge the best way to proceed.
Otherwise, nicotine patches and CBT counselling can also greatly help someone to get off smoking --- and to stay off, which is obviously the more important goal. And they could enhance rather than disturb control of the bipolar disorder.

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