Maryland's Tobacco Resource Center - Linking Professionals to Best Practices

Bupropion (Zyban)

General Information

Bupropion is an antidepressant believed to act upon norepinephrine and dopamine, two chemicals in the brain known to help regulate aspects of mood, cognition, and behavior. It has been used for the treatment of major depressive disorder, some anxiety disorders, and recently has been utilized as an aide for those attempting to quit smoking. It does not contain nicotine, but it does affect the chemicals in the brain associated with nicotine craving. It can be used in conjunction with other forms of nicotine replacement therapy. The use of Bupropion for smoking cessation is contraindicated in patients with seizure disorder, current or prior diagnoses of an eating disorder, use of Monoamine Oxidase (MAO) inhibitors within the past 14 days, or in patients taking other medications that contain Bupropion.8

Empirical Evidence on Effectiveness

A meta-analytic review of twenty-four studies revealed that bupropion SR (sustained release) approximately doubles the likelihood of long-term abstinence (greater than 5 months) from tobacco use when compared to placebo treatment8. Research has also demonstrated that Bupropion SR tripled the quit rates among women and formerly depressed smokers.4 About 25 percent of the women who had taken bupropion SR were still abstaining from smoking a year later, triple the 8.5 percent success for those using a placebo tablet. The women on the placebo pill reported more negative mood than the men in that group, but no gender differences were observed for smokers using Bupropion SR. A similar effect on abstinence rates was noted for smokers with a previous history of depression.4 Bupropion SR was also found to be effective for smoking cessation among African Americans and may be useful in reducing the health disparities associated with smoking.5 Researchers reviewed the evidence over the past decade on Bupropion and noted its efficacy in alleviating craving to smoke.6

Possible Side Effects

  • Dry mouth
  • Nausea
  • Insomnia
  • Dizziness
  • Weight loss
  • Associated with risk of seizures, which is dose-related

Links to Brand Names

Zyban: http://us.gsk.com/products/assets/us_zyban.pdf

Oral administration, 150 mg sustained release tablets

Wellbutrin: http://www.wellbutrin-xl.com

Same ingredients as Zyban; often prescribed for mood management

Once-daily, extended release tablet

Available in 150 and 300 mg doses

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References: 

1 Fiore, M.C., et al. (2000). Treating tobacco use and dependence: Clinical Practice Guideline. U.S. Department of Health and Human Services, Public Health Service.

2 Corelli, R.L., & Hudman, K.S. (2002). Medications for smoking cessation. Western Journal of Medicine, 176, 131-35.

3 Gonzales, D., et al. (2006). Varenicline, an a4ß2 nicotinic acetylcholine receptor partial agonist, vs sustained-release Bupropion and placebo for smoking cessation: A randomized controlled trial. Journal of the American Medical Association, 296, 47-55.

4 Tonstad, S. (2002). Use of sustained-release bupropion in specific patient populations for smoking cessation. Drugs, 62, 37-43.

5 Ahluwalia, J.S., et al. (2002). Sustained-release bupropion for smoking cessation in African Americans: A randomized controlled trial. Journal of the American Medical, 288, 497-99.

6 Mooney, S.E., & Sofouglu, M. (2006). Bupropion for the treatment of nicotine withdrawal and craving. Expert Review of Neurotherapeutics, 6, 965-81.

7 Stapleton JA, Watson L, Spirling LI, et al. Varenicline in the routine treatment of tobacco dependence: a pre-post comparison with nicotine replacement therapy and an evaluation in those with mental illness. Addiction 2007;103:146-54.

8 Fiore, M.C, Jaen, C.R., Baker, T.B., et al. (2008). Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service.

9 http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm124818.htm

10 West, R., Baker, C.L., Cappelleri, J.C., Bushmakin, A.G. (2008). Effect of varenicline and bupropion SR on craving, nicotine withdrawal symptoms, and rewarding effects of smoking during a quit attempt. Psychopharmacology, 197, 371-377.

11 Williams, K.E., Reeves, K.R. et al. (2007). A double-blind study evaluating the long-term safety of varenicline for smoking cessation. Current Medical Research and Opinion, 23 (4); 793-801.

12 Tonstad, S., Tonnesen, P. et al. (2006). Effect of Maintence Therapy with Varenicline on Smoking Cessation: A Randcomized Controlled Trial. Journal of the American Medical Association, 296: 64-71.

13 Schmitz, J.M., Stotts, A.L. (2007). Buproprion and cognitive-behavioral therapy for smoking cessation in women. Nicotine & Tobacco Research, 9 (7); 785.