Cytisine – is it poison? The use of cytisine in addiction therapy

A beautiful garden shrub with yellow, cluster flowers called the Laburnum anagyroides (Laburnum anagyroides) has long been known for its poisonous seeds. It is especially dangerous for horses and young children, among whom poisoning most often ends tragically. The substance responsible for the toxic properties of gold flap grains is a quinolizidine alkaloid called cytisine.

As it turns out, in addition to their ominous role, the seeds of the golden grass can be used in medicine in various ways that benefit humans. Carbohydrate-binding lectins isolated from them are used in laboratory analysis to distinguish blood groups into basic categories 0, A and B, while small amounts of cytisine, due to its chemical similarity to nicotine, are used in the form of tablets as a replacement in the treatment of addiction to this alkaloid.

Cytisine preparations used in the treatment of nicotinism in Poland are available under the trade names Tabex and Desmoxan.

Is Cytisine Safe?

It is difficult to answer this question unequivocally, because in most cases medicinal substances have both positive and negative effects on the body. The danger of using medical preparations is associated with the risk of a (often really long) list of side effects, which are side effects of combinations of various factors. At the same time, if the therapy has been prescribed by a physician, this means that the expected benefits of its use, according to the medical knowledge available to a specialist, significantly exceed the risk of using the prescribed substance. This principle applies to all pharmacological agents – including cytisine.

Treatment of nicotinism by replacing tobacco products with cytisine tablets is usually started five days before the last cigarette is smoked and continued for another 20 days. The treatment is possible thanks to the similar effects on the body of both substances, taken in small amounts and the mutual antagonization of the effects of nicotine and cytisine with simultaneous administration.

Thanks to the greater affinity of cytisine for the α4β2 nicotinic receptor, its preparations have the ability to neutralize the negative effects of nicotine withdrawal. The secretion of dopamine, a neurotransmitter functioning in the area of ​​the so-called the brain’s reward system – similar to nicotine use. Drugs based on cytisine also stimulate the secretion of adrenaline and affect the respiratory and vasomotor centers. Good to know: the presence of more adrenaline generates an increase in blood pressure.

Cytisine and the reproductive abilities of men and women

During the treatment of nicotine addiction, the psychological comfort of the patient is important. Many men are concerned about the impact of therapy on potency. The leaflets of both cytisine-based preparations available in Poland note among the side effects a weakening of the sex drive. However, it is worth considering that this is related to the nicotine-related way cytisine works on the body. In addition, the period of taking the preparation is less than a month in total (the average treatment lasts 25 days), and the substance remains in the body for only 4 hours, after which it is excreted in the urine. Most patients do not report any adverse effect of the therapy on the state of sexual life, but successful withdrawal from nicotine is often associated with a significant improvement in this respect.

Women who quit smoking are usually most terrified of the prospect of the extra pounds that magically materialize suddenly after the body is cleared of nicotine. The patient information leaflet attached to Tabex and Desmoxan notes, among the possible side effects of anti-smoking therapy with these cytisine preparations, also an increase in body weight. It is worth taking into account the fact that the risk of gaining weight is largely related to the lack of nicotine accelerating the metabolism. Increased appetite can be managed with the right kind of snacks, and weight gain will reduce physical activity, which will work on your metabolism much better than a cigarette.

The good news for the ladies will be the fact that cytisine smoking cessation pills are safe to use together with contraceptive preparations. Many gynecologists even encourage their patients to use anti-smoking therapy, because nicotine in combination with fertility control drugs significantly increases the risk of thrombosis, especially in women over 25 years of age.

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