Effects of Nicotine on Medication

Nicotine is a type of nitrogenous chemical extracted from various plants containing nitrogen, such as the tobacco plant. Synthetically manufactured tobacco is also available as over-the-counter drugs or narcotics. Nicotine is a stimulant in many individuals through the smoking or chewing of tobacco. Research shows that nicotine is highly addictive and has potential side effects on hormones, the circulatory and gastrointestinal system, affecting individuals during use or quitting (Rohsenow et al., 2017). This essay identifies the impact of nicotine on individuals using specific medication, focusing on antidepressants and oral contraception to suggest proper counseling and determine the correct dosages for patients using nicotine products while on medication.


Some antidepressant medications work more effectively with narcotic substances, while others show negative responses when used with narcotic substances. Drugs that work effectively with nicotine include olanzapine, benzodiazepine, and clozapine used by patients with severe depression (Rohsenow et al., 2017). Narcotic substances either inhibit or induce cytochromes p450 (CYP) enzymes responsible for metabolizing drugs through oxidation, determining the reaction of Fluvoxamine, duloxetine, and mirtazapine drugs (Rohsenow et al., 2017). Nicotine concentrations lower blood levels in Fluvoxamine by inducing CYP1A2 during metabolism, inhibiting the reuptake of serotine. Narcotic substances affect the effective mediation of duloxetine by decreasing its bioavailability through increasing CYP1A2 enzymes in metabolizing duloxetine.

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Therefore, the reactions of these drugs with nicotine have mild to adverse effects depending on the level of concentration. An imbalance in serotine levels causes increased depression, diarrhea, chills, and confusion. Adverse effects include high fevers, high blood pressure, and muscle paralysis in extreme events (Rohsenow et al., 2017). In addition, smokers who suffer from depression are likely to have difficulties quitting, leading to adverse withdrawal symptoms.

Oral Contraception

Oral contraception methods involve medication containing high levels of progestin and estrogen. Women who use oral contraception while exposed to nicotine substances have higher chances of developing circulatory system diseases such as heart attacks and Cardiac Ischemia (Rohsenow et al., 2017). Nicotine elevates the risk of arterial disease when used concurrently with oral contraception containing estrogen, which reacts by inducing hypercoagulability and blood thrombosis in the circulatory system leading to cardiovascular attacks. Older women above the age of 35 have a higher risk of developing cardiovascular disease than younger women, leading to more deaths due to age and substance abuse (Rohsenow et al., 2017). Other contraceptives containing estrogen also enhance higher chances of heart diseases when combined with narcotic substances.

Addressing Clients on the Use of Nicotine with Medication

Individuals who are on antidepressant medication and exposed to nicotine should quit using nicotine substances. Before any treatment, smokers and nicotine users should know the effects of stopping nicotine use and how to manage the situation. Studies recommend the stabilization of depression through counseling and taking antidepressants in moderating the gradual changes when quitting (Rohsenow et al., 2017). Alternatively, cognitive management on behavioral and mood changes may treat nicotine users who have recurrent depression. Additionally, lifestyle changes in individuals taking antidepressants limit the risk of toxicity and side effects associated with concurrent use of medication and nicotine substances. Adjusting antidepressant drug dosages also helps ensure the balance of serotine levels in individuals who use nicotine (Rohsenow et al., 2017). Finally, women are advised to take oral contraception with fewer estrogen levels, contributing to the elevation of circulatory diseases like blood thrombosis.


Rohsenow, D. J., Tidey, J. W., Martin, R. A., Colby, S. M., Swift, R. M., Leggio, L., & Monti, P. M. (2017). Varenicline versus nicotine patch with brief advice for smokers with substance use disorders with or without depression: Effects on smoking, substance use, and depressive symptoms: (alcoholism and drug addiction). Addiction, 112(10), 1808-1820. Web.

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