Effect of Bupropion on Depression Symptoms in a Smoking Cessation Clinical Trial.

Lerman, Caryn; Niaura, Ray; Collins, Bradley N.; Wileyto, Paul; Audrain-McGovern, Janet; Pinto, Angela; Hawk, Larry W.; Epstein, Leonard H.

doi:10.1037/0893-164x.18.4.362

Cited by 60 publications

(26 citation statements)

References 24 publications

(49 reference statements)

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“…Yet, the failure of some antidepressants to improve cessation rates suggests that negative affect per se is unlikely to be any more sensitive than other withdrawal symptoms as a measure of a medication's clinical efficacy for smoking cessation (Hughes et al 2004). Further emphasizing this point is the observation that bupropion was subjected to clinical trials for cessation not on the basis of its antidepressant actions but on the basis of anecdotal observations of spontaneous abstinence among depressed smokers already taking the drug as Welbutrin (Martinez-Raga et al 2003; see also Lerman et al 2004). Similarly, relief of anxiety, another common withdrawal symptom, has provided the justification for clinical trials of a few anxiolytic medications, but none has shown efficacy for smoking cessation (Benowitz and Peng 2000).…”

Section: Research On Mechanisms Of Actionmentioning

confidence: 95%

Medication screening for smoking cessation: a proposal for new methodologies

Stitzer²,

2005

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The clinical validity of short-term screening studies may improve if these studies simulate some clinical trial procedures within practical limitations. Thus, they should recruit smokers motivated to abstain, emphasize smoking abstinence as a primary index of medication response, examine effects over sufficiently long time periods to encompass the drug's mechanism of action, and assess responses in the natural environment. Whether these changes improve the sensitivity of screening studies is testable. Other research aimed specifically at identifying the mechanisms of therapeutic action of a medication may also profit from using this approach of simulating a short-term clinical trial.

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Section: Research On Mechanisms Of Actionmentioning

confidence: 95%

Medication screening for smoking cessation: a proposal for new methodologies

Stitzer²,

2005

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“…A pesar de no estar claro su funcionamiento, el Bupropion (Zyntabac) parece aumentar los niveles de dopamina y norepinefrina actuando como antagonista de la nicotina por su capacidad para bloquear las subunidades α3β2 y α3β4 de los receptors colinérgicos nicotínicos (Lerman et al, 2004;Benowitz, 2008b;Xi, Spiller y Gardner, 2009). A igual que la terapia sustitutiva de la nicotina, el Bupropion está recomendado como fármaco de primera línea en el tratamiento del tabaquismo (Fiore et al, 2008), mostrando aproximadamente el doble de éxito en comparación con el placebo en estudios de meta-análisis (Henningfield, Fant y Buchhalter, 2005).…”

Section: Farmacología Y Estrategias Para El Ma-nejo Del Craving Por Lunclassified

Aspectos neuropsicológicos del craving por la nicotina

Muñoz¹,

Sanjuan²,

Fernández‐Santaella³

et al. 2011

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Craving has been defined as the motivation to self-administer a substance previously consumed. It has been hypothesized that craving contributes significantly to compulsive drug use and relapse after a period of abstinence in humans. Neuropsychological and brain-imaging studies have identified numerous brain regions that may be involved in craving. In this paper, the neuropsychological mechanisms of craving for nicotine are reviewed, focusing on three systems that appear to be involved in craving states. First of all, the reward system, responsible for the development of dependence and craving. Secondly, the emotional and associative system, which is related to conditioned craving. And third, the system involved in the neural basis of cognitive and decisionmaking processes. The most influential theoretical models on craving are also reviewed, including those based on conditioning mechanisms, on cognitive mechanisms and on cognitive-behavioral mechanisms, as well as the neurobiological model. Factors related to the evaluation and treatment of craving are also discussed, with particular emphasis on clinical aspects. Finally, we stress the importance of a multidisciplinary approach for achieving a common model on craving and improving the diagnostic tools and treatment strategies.Key words: craving, smoking, neuropsychological mechanisms, nicotine dependence, theoretical models. RESUMEN ABSTRACTEl craving se ha definido como la motivación de autoadministrarse una sustancia que previamente ha sido consumida. Se considera que el craving es responsable del consumo compulsivo de una sustancia, así como del alto nivel de recaídas después de periodos de abstinencia. Los estudios neuropsicológicos y de imagen cerebral han identificado numerosas regiones cerebrales implicadas en el craving. En este artículo se revisan los mecanismos neuropsicológicos implicados en el craving por la nicotina, centrándose en los tres sistemas involucrados en el craving. Primero, el sistema de recompensa, responsable del desarrollo de la dependencia y del craving. Segundo, el sistema emocional y asociativo que se relaciona con el craving condicionado. Tercero, el sistema implicado en la toma de decisiones y procesos cognitivos. Además, se revisa los modelos teóri-cos más influyentes, como los Modelos basados en el Condicionamiento, Modelos Cognitivo-Conductuales, Modelos Cognitivos y Modelo Neurobiológico. También se discuten otros aspectos relacionados con la evaluación y tratamiento del craving, haciendo énfasis en los aspectos clínicos. Como conclusión, se acentúa la importancia de un enfoque multidisciplinar para lograr un modelo común del craving, así como para mejorar las herramientas diagnósticas y las estrategias de tratamiento.

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“…A limitation of this study is the fact that the population of smokers had low scores of depression and therefore we don't know if cognitive-behavioral treatment for depression could be more beneficial in smokers with higher depression scores. In a previously published study it has been shown that this type of treatment is effictive only for smokers with recurrent major depression [Lerman et al 2004].…”

Section: Treatment With Other Antidepressantsmentioning

confidence: 99%

Smoking and depression: is smoking cessation effective?

Ischaki

Gratziou

2009

Ther Adv Respir Dis

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Patients with depression tend to have a higher rate of smoking and an increased severity of nicotine dependence. It seems that common genetic and environmental factors may influence the bimodal relationship between smoking and depression. Nicotine has some positive reinforcing/rewarding effects that may affect people with mood disorders and smoking is also used as a 'relief medication' in order to ameliorate symptoms of depression, as it is already known that nicotine, which is the major psychoactive ingredient in tobacco, may act as an antidepressant. To date, the data regarding the difficulty in smoking cessation in depressed smokers are conflicting. Low confidence and self-esteem among this group of smokers are significant predictors of failure during smoking cessation attempt. In the most recently published guidelines for smokers with psychiatric comorbidities the suggestion is for combination treatment (counseling and pharmaceutical treatment) and prolongation of a therapeutic approach.

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Effect of Bupropion on Depression Symptoms in a Smoking Cessation Clinical Trial.

Cited by 60 publications

References 24 publications

Medication screening for smoking cessation: a proposal for new methodologies

Medication screening for smoking cessation: a proposal for new methodologies

Aspectos neuropsicológicos del craving por la nicotina

Smoking and depression: is smoking cessation effective?

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