Bupropion for the treatment of tobacco dependence: Guidelines for balancing risks and benefits

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

Tobacco use, particularly cigarette smoking, is now a global pandemic. The expected morbidity and mortality from smoking-attributable diseases will continue to rise for the next 30 years. In order to reduce this negative impact on worldwide health, effective therapy to aid smoking cessation must be provided to current smokers. Treatment for tobacco dependence involves the combination of behavioural therapies and pharmacological treatment. The most common pharmacological treatments include nicotine replacement therapy and non-nicotine medications, including antidepressants. The antidepressant with the greatest weight of evidence for efficacy in the treatment of tobacco dependence is bupropion. Sustained-release bupropion is approved for the treatment of tobacco dependence in over 50 countries worldwide. The efficacy of bupropion for the treatment of tobacco dependence is attributed to the blockage of dopamine reuptake in the mesolimbic dopaminergic system. This area of the brain is believed to mediate reward for nicotine use and for other drugs of dependence. Randomised, controlled clinical trials have shown that bupropion approximately doubles abstinence rates compared with placebo. In addition, long-term treatment with bupropion may reduce or delay smoking relapse. Bupropion also appears to be effective in the treatment of smokers who have recently relapsed and smokers with other comorbid psychiatric conditions. Bupropion has a good adverse events profile, but the risk exists for serious adverse effects such as seizures. Recent postmarketing surveillance reports have raised safety concerns about bupropion, although no causal relationship between bupropion and the reported serious adverse events or death has been established.

Original languageEnglish (US)
Pages (from-to)71-83
Number of pages13
JournalCNS Drugs
Volume17
Issue number2
DOIs
StatePublished - 2003

Fingerprint

Bupropion
Tobacco Use Disorder
Guidelines
Therapeutics
Smoking
Nicotine
Antidepressive Agents
Pharmacology
Tobacco Use
Pandemics
Smoking Cessation
Reward
Substance-Related Disorders
Psychiatry
Dopamine
Seizures
Randomized Controlled Trials
Placebos
Morbidity
Safety

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Neuropsychology and Physiological Psychology
  • Pharmacology

Cite this

Bupropion for the treatment of tobacco dependence : Guidelines for balancing risks and benefits. / Hays, James Taylor; Ebbert, Jon Owen.

In: CNS Drugs, Vol. 17, No. 2, 2003, p. 71-83.

Research output: Contribution to journalArticle

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