Worsening of chorea during smoking cessation therapy with cytisine: A case report

Cytisine is an effective, inexpensive, affordable, and well-tolerated drug for smoking cessation treatment, and it has been used for many years in some parts of the world. Recent studies confirm its significance in anti-smoking efficacy with no serious safety signals or expected drug interactions. We present a case of a 62-year-old patient with a history of choreic syndrome on tetrabenazine therapy who experienced worsening neurological symptoms during smoking cessation therapy with cytisine. It is conceivable that cytisine therapy could reduce the desensitization of α6β2 nAChR and increase dopamine release, worsening the chorea. The present case report may help bring attention to some not yet described interactions of cytisine in humans, and the role of the drug in people with tobacco addiction and underlying neurological conditions. Clinicians should be aware of possible interactions between cytisine and other drugs or pathological conditions in which the same neurotransmitter pathways are involved.