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Question 1: A 50 year old man with a history of hypertension and tobacco use comes to clinic for follow up as he tries to stop smoking. He’d been started on varenicline 8 weeks ago, and has been calling 1 800 QUIT NOW for behavioral counseling. The patient is still suffering from nicotine cravings and continues to smoke. What is the best next step in management?

  1. The patient should continue with the same treatment

  2. Varenicline should be discontinued, and bupropion started

  3. Varenicline should be discontinued, and nicotine replacement therapy started.

  4. Varenicline should be continued, the patient should continue to call 1 800 QUIT NOW, and nicotine replacement therapy should be added to his regimen.

Reference: Rigotti NA. Pharmacotherapy for smoking cessation. In: UpToDate, Stoller JK, Aronson MD, Park L (Ed), UpToDate, Waltham, MA. (Accessed on February 26 2016.)

Question 2: Which class of medications has demonstrated the greatest efficacy in the treatment of sexual addiction?

  1. Opioid antagonists

  2. Stimulants

  3. Tricyclic antidepressants

  4. SSRI’s

  5. Dopamine agonists

 

Reference: Miles, L. A., Cooper, R. L., Nugent, W. R., & Ellis, R. A. (2015). Sexual Addiction: A Literature Review of Treatment Interventions. Journal of Human Behavior in the Social Environment, 1-12.

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