Progesterone Aids in Alleviation of Nicotine Withdrawal Symptoms: A Systematic Review

Abstract

Background: A systematic review of studies on progesterone’s usage in the cure of nicotine craving was undertaken. Progesterone is a steroid hormone that influences the reproductive system as well as -Aminobutyric acid type A (GABAA) receptors, glycine, kainite, and nicotinic receptors. It is thought that progesterone might help with nicotine withdrawal symptoms in addicted people. Method: Two authors completed the literature search independently using the Boolean search approach and searching key terms (i.e. progesterone AND treat*, drug addiction AND withdrawal, smok*, nicotine), screened the title, abstract and full-text for data extraction during June 2021. A search in the PubMed, NIH, Elsevier, Scopus, Web of Science, Google Scholar, and Science Direct databases was performed. The review included seven (7) articles out of seventy-eight (78) downloaded articles that met the inclusion criteria. Microsoft Excel and IBM SPSS were used for statistical analysis. Results: These studies included 147 males and 377 females, out of which 46 were pregnant. The average age ranged between 18 and 45 years. The participants included those who had smoked 10-25 cigarettes/day for a year. The carbon monoxide measuring over 10ppm signifies recent smoking was found in 10% (n=12) participants who were given 400mg progesterone, 11% (n=14) for the 200 mg progesterone, and 13% (n=16) for the placebo groups. The progesterone prescription of 400 mg/day was effective in decreasing cravings to smoke, while the 200 mg dose helped with improving cognitive performance. Females in the progesterone group exhibited significantly lower smoking craving scores than females in the placebo group. A significant difference has been observed in 7-day PPA at week 4 among women i.e. “PRO: 18 (35.3%) vs. PBO: 9 (17.3%), Odds Ratio: 2.61 (95% confidence interval) and p=0.041”, but not among men i.e. “PRO: 13 (23.2%) vs. PBO: 12 (21.1%), 1.13 (0.47, 2.76) and p=0.782”. There was some evidence that PRO delayed relapse in women (Days to Relapse; PRO: 20.5 ±29.6 vs. PBO: 14.3 ±26.8, p=0.03) but not in men (PRO: 13.4 ±25.9 vs. PBO: 13.3 ± 23.8, p=0.69). Nearly half of the females who smoke before pregnancy can quit smoking during pregnancy. However, 40-52% reverts within 2 weeks while 70-80% resumes smoking within a year of childbirth. Conclusion: In the majority of instances, 200mg was administered, and favorable outcomes were obtained. Although there were no major side effects observed, a few moderate side effects such as breast tenderness were reported in a few individuals. As a result, progesterone therapy helps to alleviate nicotine withdrawal symptoms, lowers smoking intensity, and treats smoking addiction in both men and women. Keywords: progesterone, prescription, treatment, drug addiction, withdrawal, smoking, nicotine