A controlled trial of nortriptyline, sustained-release bupropion and placebo for smoking cessation: preliminary results

Haggstrãm, Fábio Maraschin; Chatkin, José Miguel; Sussenbach-Vaz, Eliana; Cesari, Débora H.; Fam, Cláudia Franzoi; Fritscher, Carlos Cézar

doi:10.1016/j.pupt.2005.05.003

Cited by 44 publications

(23 citation statements)

References 17 publications

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“…35,41 Neither found any significant difference in abstinence rates as a function of medication assignment. Comparisons of bupropion SR with varenicline, in contrast, indicate that a regimen of 2 mg of varenicline daily is associated with a significant increase in the likelihood of abstinence relative to 300 mg of bupropion SR. [31][32][33] A recent meta-analysis 24 found that varenicline increased the odds of quitting by an odds ratio of 2.18 (95% Credible Interval = 1.09-4.09) over bupropion SR.…”

Section: Comparative Efficacymentioning

confidence: 87%

“…38 Randomized controlled trials in other countries (or in multiple countries) have supported the efficacy of bupropion SR in promoting abstinence, relative to placebo, up to six months or one year postquit. [39][40][41] Another multi-country trial reported that bupropion SR only resulted in statistically significant increases in abstinence rates relative to placebo while treatment was ongoing and not beyond, however. 42 In summary, randomized, placebo-controlled clinical trials of generally healthy smokers strongly support the efficacy of bupropion SR in promoting abstinence from smoking while treatment is ongoing (usually 7-12 weeks).…”

Section: Trials Of Efficacy In Healthy Adult Daily Smokersmentioning

confidence: 99%

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Treatment Options in Smoking Cessation: What Place for Bupropion Sustained-Release?

McCarthy

Jorenby

Minami

et al. 2009

Clinical Medicine. Therapeutics

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Bupropion SR is approved for the treatment of tobacco dependence in adult smokers. Bupropion SR is an atypical antidepressant that has been shown to double the likelihood of quitting smoking (to roughly 19%-24% six months into a quit attempt), perhaps by acting on dopaminergic and noradrenergic systems and by acting as an antagonist of nicotine acetylcholine receptors. Head-to-head comparisons of bupropion SR and other stop-smoking treatments suggest that bupropion SR is as or more efficacious than nicotine replacement therapies, equally efficacious as nortriptyline, and less efficacious than varenicline. The evidence available regarding the effectiveness of bupropion SR in real-world settings suggests that abstinence rates are similar to those seen in controlled clinical trials. Bupropion SR appears to be safe and efficacious for both men and women and for people with comorbid medical or mental health conditions. Evidence collected to date supports the use of bupropion SR as a safe, tolerable pharmacotherapy for smoking cessation among adult smokers without a predisposition to seizures, but also suggests that benefits in terms of abstinence last only as long as treatment continues. This review focuses on recent evidence regarding bupropion SR effects and highlights important questions regarding the duration of effects, relative efficacy, effectiveness in clinical use, mechanisms of action, and utilization of bupropion SR that remain unanswered.

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Section: Comparative Efficacymentioning

confidence: 87%

Section: Trials Of Efficacy In Healthy Adult Daily Smokersmentioning

confidence: 99%

Treatment Options in Smoking Cessation: What Place for Bupropion Sustained-Release?

McCarthy

Jorenby

Minami

et al. 2009

Clinical Medicine. Therapeutics

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show abstract

“…Compared to placebo. Three trials showed significant improvement in abstinence rates [60,62,63], and 3 others did not show significant improvement over placebo [64][65][66]. Combining the data, nortriptyline approximately doubled the quit rates compared to placebo (OR:2.03; CI:1.48-2.78) [8].…”

Section: Nortriptylinementioning

confidence: 92%

An update on the pharmacotherapeutic interventions for smoking cessation

Barboza

Patel

et al. 2016

Expert Opinion on Pharmacotherapy

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“…However, no additional benefit of nortriptyline was noted if added to NRT (relative cessation rate, 1.29, 95% CI, 0.97-1.72). In three trials that directly compared nortriptyline with bupropion, none showed any significant difference between both agents [138][139][140], and although the pooled analysis slightly favoured bupropion, the odds ratio for smoking cessation was non-significant (1.30; 95% CI 0.93-1.82) [126].…”

Section: Nortriptylinementioning

confidence: 94%

Nicotine Addiction and Coronary Artery Disease: Impact of Cessation Interventions

Gaemperli¹,

Liga²,

Bhamra-Ariza³

et al. 2010

CPD

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Cigarette smoking is the leading preventable cause of death worldwide, and a considerable proportion of smoking-related fatalities are attributable to coronary artery disease (CAD). The detrimental effects of smoking span all stages in the development of CAD ranging from the early functional alterations in the endothelium and the microcirculation to the late clinicopathological manifestations of atherosclerotic plaques. Smoking results in the generation of free radicals and increased oxidative stress which plays a central role in the pathogenetic mechanisms leading to atherosclerotic disease. It causes reduced nitric oxide bioavailability and lipid peroxidation which are crucial initial steps of plaque formation. Furthermore, smoking enhances leukocyte and platelet activation and promotes local and systemic inflammation, which contribute to plaque progression and maturation. Finally, alterations in fibrinolytic and prothrombotic factors create a pro-thrombogenic environment which harbours the risk of plaque rupture and thrombosis. In smokers, the cessation of smoking is the most important intervention for cardiovascular risk reduction. Total mortality can be reduced by 36% which is comparable to established modern secondary preventive therapies. Nonetheless, non-aided cessation attempts are notoriously poor with a success rate of less than 10%. Patient counselling and pharmacological therapies are important aides for smoking cessation and can improve success rates by two to threefold. However, there is still need for improved strategies of smoking cessation to reduce the high socioeconomic impact of smoking.

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A controlled trial of nortriptyline, sustained-release bupropion and placebo for smoking cessation: preliminary results

Cited by 44 publications

References 17 publications

Treatment Options in Smoking Cessation: What Place for Bupropion Sustained-Release?

Treatment Options in Smoking Cessation: What Place for Bupropion Sustained-Release?

An update on the pharmacotherapeutic interventions for smoking cessation

Nicotine Addiction and Coronary Artery Disease: Impact of Cessation Interventions

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