Quitting smoking is not easy. Contacting anti-smoking centers can often make the difference. And since tobacco addiction is not only a psychological problem, but also a real physical addiction, medications can also help. The latest innovation in this field comes from Eastern Europe: it is cytisine, a natural drug available for some time in our country in the form of a galenic preparation, and which also arrived last December with a commercial product, defucitan, therefore available in all pharmacies upon prescription from your doctor. Let’s see what it’s about.
What is it about?
Cytisine is a natural alkaloid present in several plants of the Fabaceae family. It is mainly extracted from laburnum, and has an interesting history. Its association with tobacco consumption dates back to the Second World War, when – it is said – Soviet soldiers found themselves without cigarettes, and began smoking laburnum leaves, discovering that it was an ideal substitute for tobacco leaves.
What is certain is that starting from the 1960s it began to be studied as an aid in combating nicotine addiction. With positive results, which led to its adoption in all the countries of the former Soviet bloc. The situation is different in Western Europe, where the lack of quality clinical data (the Soviet ones were not considered sufficient) delayed the study and then the adoption of cytisine in the pharmaceutical field for decades.
Recent results
A first demonstration of the effectiveness of cytisine in the cessation of tobacco addiction came in 2011 with a study published in the New England Journal of Medicine, in which when tested against a placebo, the substance revealed that it doubled the chances of being able to abstain from consuming tobacco. cigarettes. In the following years, other studies were carried out, with sometimes conflicting results, until a recent meta-analysis by the Cochrane collaboration, according to which this substance is able to double the chances of actually quitting smoking for the six months following a cycle of treatment.
The mechanism of action is linked to the ability of cytisine to act as an agonist of nicotine receptors in the brain: practically the substance binds to the same receptors that are activated by nicotine, giving a similar sensation without the need for smoking, and thus making it easier deal with tobacco withdrawal. It also seems to induce a feeling of nausea when smoking, and to make cigarettes taste unpleasant, all of which contribute to the anti-tobacco effect.
How to take it
Cytisine is a drug not without side effects, and potentially capable of interfering with other medicines or with pre-existing pathologies, and therefore a doctor’s prescription is required (usually that of an anti-smoking center or a family doctor) for be able to buy it in the pharmacy. The treatment, which is calibrated by the doctor based on the needs and response of each individual patient, involves the intake of approximately 2-6 capsules of one and a half milligrams per day, for a period of 40 days, which can be extended up to at around 60.
For its part, cytisine has an effectiveness that seems at least comparable to other anti-smoking drugs such as varenicline and buproprion, but with a price several hundred euros lower for a course of treatment. The drug defucitan costs more or less 100 euros for 25 days of therapy (all paid by the patient), while for the equivalent galenic preparation you spend a little less than half. However, it is not always easy to find a pharmacy equipped to prepare oral galenic formulations, and therefore the availability of a commercial drug could help more people have access to cytisine.