Mediating mechanisms for the impact of bupropion in smoking cessation treatment

Lerman, Caryn; Roth, David L.; Kaufmann, Vyga; Audrain, Janet; Hawk, Larry W.; Liu, Aiyi; Niaura, Ray; Epstein, Leonard H.

doi:10.1016/s0376-8716(02)00067-4

Cited by 143 publications

(122 citation statements)

References 10 publications

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“…The findings accord with growing evidence that antidepressants may be used to reduce affective distress following quitting smoking (Hall et al 1998;Shiffman et al 2000;Lerman et al 2002). Notably, fluoxetine produced a reduction in negative affect and a rise in positive affect.…”

Section: Discussionsupporting

confidence: 84%

“…1), resulting in assessments of positive mood that exceeded pre-quit levels. The positive affect pattern that emerged for the 60 mg group is strikingly different than reported losses in positive affect in the placebo group and in others abstaining from nicotine (Gilbert et al 1998;Lerman et al 2002;Cook et al 2003). Fluoxetine appears to have not only reversed typical reported losses in positive affect following smoking, but stimulated a positive mood improvement that continued to grow 8 weeks after quitting smoking.…”

Section: Discussionmentioning

confidence: 56%

“…That neglect is surprising, given the integral relationship between deficient positive mood states and depression (Clark and Watson 1991;Coyne 1994), and evidence that quitting smoking heightens the risk of depressive episodes (Borrelli et al 1996;Tsoh et al 2002). Positive affect declines after quitting smoking (Gilbert et al 1998;Lerman et al 2002;Cook et al 2003) and persists across 30 days of abstinence (Gilbert et al 1998). Further, empirical evidence that positive and negative affect are linked to different neural underpinnings (Davidson 1992) and have different psychological correlates (Watson et al 1988) supports the independence of these constructs.…”

Section: Introductionmentioning

confidence: 99%

“…Studies on the effects of the agents have, for the most part, focused on the alleviation of negative mood or depressive symptoms. Specifically, euthymic smokers treated with nortryptiline (catecholaminergic and serotonergic actions) or bupropion (dopaminergic and noradrenergic actions), report lower levels of post-cessation negative affect than smokers who did not receive these treatments (Hall et al 1998;Shiffman et al 2000;Lerman et al 2002). Effects of antidepressants on positive affect are less understood (Zald and Depue 2001).…”

Section: Introductionmentioning

confidence: 99%

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Influence of fluoxetine on positive and negative affect in a clinic-based smoking cessation trial

et al. 2004

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Rationale-Fluoxetine improves affect in clinical syndromes such as depression and premenstrual dysphoric disorder. Little is known about fluoxetine's influence on mood changes after quitting smoking, which often resemble sub-clinical depression.Objectives-The present study, a re-analysis of previously published data , examined fluoxetine's effect on changes in negative and positive affect following quitting smoking.Methods-Adult smokers (n=175) without clinically significant depression were randomized on a double-blind basis to receive fluoxetine hydrochloride (30 or 60 mg daily) or placebo for 10 weeks in combination with cognitive-behavioral therapy (CBT) for smoking cessation. We postulated that fluoxetine would beneficially influence post-cessation changes in positive and negative affect.Results-Mood change across treatment was analyzed using mixed linear modeling controlling for initial level of nicotine dependence, plasma fluoxetine metabolites, and change in cotinine (a nicotine metabolite) at each visit. Relative to placebo, those on 60 mg fluoxetine experienced an elevation in positive affect that increased across time [t(526) Conclusions-Results indicate that 60 mg of fluoxetine improves both positive and negative mood states after quitting smoking and that diminished positive affect may be an overlooked affective response to smoking cessation.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Influence of fluoxetine on positive and negative affect in a clinic-based smoking cessation trial

et al. 2004

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“…Consistent with an enhanced response to NRT among Asp40 carriers, these smokers had attenuated weight gain and fewer symptoms of mood disturbance. The magnitude of differences in NRT outcomes between these subgroups defined by OPRM1 genotype is also clinically significant, in that it is comparable to the differences in abstinence rates 17,23 weight gain 24 and abstinence symptoms 25 achieved when comparing active pharmacotherapies with placebo. Consistent with previous research, 19 males had a more favorable response to NRT (independent of treatment type) than females.…”

Section: Discussionmentioning

confidence: 90%

The functional mu opioid receptor (OPRM1) Asn40Asp variant predicts short-term response to nicotine replacement therapy in a clinical trial

et al. 2004

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To determine whether the functional mu-opioid receptor (OPRM1) Asn40Asp variant predicts the comparative efficacy of different forms of NRT, we conducted a clinical trial of transdermal nicotine (TN) vs nicotine nasal spray (NS) in 320 smokers of European ancestry. Smokers carrying the OPRM1 Asp40 variant (n ¼ 82) were significantly more likely than those homozygous for the Asn40 variant (n ¼ 238) to be abstinent at the end of treatment, and reported less mood disturbance and weight gain. The genotype effect on treatment outcome was most pronounced among smokers receiving TN, particularly during the 21 mg dose phase. Smokers who carry the OPRM1 Asp40 variant are likely to have a favorable response to TN and may benefit from extended therapy with the 21 mg dose.

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Six-Month Trial of Bupropion With Contingency Management for Cocaine Dependence in a Methadone-Maintained Population

Poling¹,

Oliveto²,

Petry³

et al. 2006

Arch Gen Psychiatry

155

142

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Context:No effective pharmacotherapies exist for cocaine dependence, although contingency management (CM) has demonstrated efficacy.Objective: To compare the efficacy of bupropion hydrochloride and CM for reducing cocaine use in methadone hydrochloride-maintained individuals.Design: This 25-week, placebo-controlled, doubleblind trial randomly assigned participants to 1 of 4 treatment conditions: CM and placebo (CMP), CM and 300 mg/d of bupropion hydrochloride (CMB), voucher control and placebo (VCP), or voucher control and bupropion (VCB).Setting: Outpatient clinic at the Veterans Affairs Connecticut Healthcare System. Participants: A total of 106 opiate-dependent, cocaineabusing individuals.Interventions: All study participants received methadone hydrochloride (range, 60-120 mg). Participants receiving bupropion hydrochloride were given 300 mg/d beginning at week 3. In the CM conditions, each urine sample negative for both opioids and cocaine resulted in a monetary-based voucher that increased for consecutively drug-free urine samples during weeks 1 to 13. Completion of abstinence-related activities also resulted in a voucher. During weeks 14 to 25, only completion of activities was reinforced in the CM group, regardless of sample results. The voucher control groups received vouchers for submitting urine samples, regardless of results, throughout the study.Main Outcome Measure: Thrice-weekly urine toxicologic test results for cocaine and heroin.Results: Groups did not differ in baseline characteristics or retention rates. Opiate use decreased significantly, with all treatment groups attaining equivalent amounts of opiate use at the end of the study. In the CMB group, the proportion of cocaine-positive samples significantly decreased during weeks 3 to 13 (PϽ.001) relative to week 3 and remained low during weeks 14 to 25. In the CMP group, cocaine use significantly increased during weeks 3 to 13 (PϽ.001) relative to week 3, but then cocaine use significantly decreased relative to the initial slope during weeks 14 to 25 (PϽ.001). In contrast, by treatment end, the VCB and VCP groups showed no significant improvement in cocaine use. Conclusion:These findings suggest that combining CM with bupropion for the treatment of cocaine addiction may significantly improve outcomes relative to bupropion alone.

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Mediating mechanisms for the impact of bupropion in smoking cessation treatment

Cited by 143 publications

References 10 publications

Influence of fluoxetine on positive and negative affect in a clinic-based smoking cessation trial

Influence of fluoxetine on positive and negative affect in a clinic-based smoking cessation trial

The functional mu opioid receptor (OPRM1) Asn40Asp variant predicts short-term response to nicotine replacement therapy in a clinical trial

Six-Month Trial of Bupropion With Contingency Management for Cocaine Dependence in a Methadone-Maintained Population

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