What is the role of bupropion in the treatment of nicotine addiction?

Updated: Jul 16, 2018
  • Author: R Gregory Lande, DO, FACN; Chief Editor: Glen L Xiong, MD  more...
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Bupropion acts by alleviating some of the symptoms of nicotine withdrawal, which include depression. [42, 43] One clinical trial demonstrated that highly nicotine-dependent smokers who receive bupropion are more likely to experience a decrease in depressive symptoms during active treatment. Like NRT products, bupropion has been endorsed by the US Clinical Practice Guideline as a first-line therapy. [4]

Compared with placebo, bupropion approximately doubles smoking cessation rates, and it is equally effective for men and women. It may yield higher cessation rates when combined with NRT than when used alone. However, Planer et al found that bupropion was not effective in hospitalized patients with acute coronary syndrome (patients who are at high risk for subsequent ischemic events) despite continuous and intensive nurse counseling about smoking cessation. [44]

The recommended and maximum dosage of bupropion is 300 mg/day, given as 150 mg twice daily. Dry mouth and insomnia are the most common adverse events associated with use. A very small risk of seizure exists, which can be reduced by not prescribing the medication to persons with a history of seizure or a predisposition toward seizure.

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