Lexotan (Bromazepam) to Quit Smoking While on Cipralex and Lithium?

Reader’s Question

I have been meeting regularly with my family physician who has been prescribing me 300mg of lithium carbonate twice a day and 10mg of Cipralex every alternate day. I have started smoking again recently and want to quit. I had a previous successful attempt by taking small doses of Lexotan (bromazepam), about 1.5mg to 3mg, for the first week that I had quit smoking. However, at that time I was not on any other medication. I am planning to go to my family physician to ask once again for the prescription of Lexotan to help me quit smoking again but do not know if it is contraindicated with the medications I am taking currently. I am a 26-year-old male and healthy otherwise.

Our Clinical Psychologist’s Reply

Your physician is the best person to evaluate your medication regimen and your needs. Here, however, are some things for you to consider:

Bromazepam is the generic name of a drug that belongs to the class of sedative/hypnotic/depressants called benzodiazepines. It’s in the same class as drugs like Valium, Klonopin, Xanax, Ativan and Librium. These drugs also have muscle-relaxant and anxiolytic (anxiety-reducing) properties. With the advent of the selective serotonin re-uptake inhibitors (SSRIs) like Prozac, Lexapro, and Cipralex, which also have anxiolytic properties, prescriptions for the benzodiazepines became less frequent, most especially because of their potential for misuse and dependence.

It’s my understanding that the manufacturer discontinued Lexotan in the UK in 2002 primarily because with the abundance of other benzodiazepines and with the more common use of the SSRIs, it did not appear to warrant the costs of marketing and distribution.

Persons who quit smoking sometimes experience heightened anxiety for a time that medication can help alleviate. You may have experienced this before when trying to quit. However, you also indicate that at that time you weren’t on your present medication regimen which includes a medicine with anti-anxiety properties.

It would be best to discuss all of your concerns with your physician. Given all of the circumstances, she or he may modify your regimen or make other recommendations. Some general practitioners might not feel comfortable prescribing a wide range of psychoactive drugs and might either make a referral to or consult with a psychiatrist or other physician specializing in the area that best serves your needs. There are continual advances in drug therapies, and only a comprehensive assessment of your situation can determine the best regimen for you.