Non-Nicotine Pharmacotherapy for Smoking Cessation

Bupropion SR worsens mood during marijuana withdrawal in humans

“…However, this appears unlikely, given that bupropion has an opposite pattern of effects when used to treat nicotine dependence. Specifically, approximately 30-50% of patients receiving bupropion for nicotine dependence report insomnia, while also reporting fewer symptoms of depression, irritability, and difficulty concentrating compared to placebo treatment (Ferry 1999;Jorenby et al 1999;Schiffman et al 2000). These data demonstrate that bupropion's effect on mood and sleep are dissociable.…”

“…Our hypothesis that bupropion might be effective for marijuana withdrawal because it shares the same constellation of symptoms as nicotine withdrawal, for example, insomnia, irritability, restlessness, depressed mood, was not supported. Nicotine and cannabinoids have distinct mechanisms of action, and there are distinct neurobiological adaptations associated with repeated administration of each drug (Rodriguez de Fonseca et al 1997;Ferry 1999), which most likely account for the divergent effects of bupropion in chronic tobacco and marijuana smokers. Although it is possible that lower doses of bupropion might produce less stimulant effects, and improve the mood symptoms of marijuana withdrawal, the present data suggest that bupropion does not show promise as an effective medication to treat individuals seeking treatment for chronic marijuana use.…”

Examining the clinical efficacy of bupropion and nortriptyline as smoking cessation agents in a rodent model of nicotine withdrawal

“…Although bupropion's mechanism of action is uncertain, it appears to act on a number of brain pathways involved in dependence (Warner and Shoaib 2005). It is known to inhibit the neuronal reuptake of dopamine in the mesolimbic system (Ferris et al 1983;Ascher et al 1995), the pathway implicated in the reinforcing effects of nicotine (Corrigall et al 1992), and noradrenaline in the locus coeruleus (LC; Ferry 1999), which is thought to be involved in nicotine withdrawal (Leshner 1996). Bupropion also acts as an antagonist for neuronal nicotinic acetylcholine receptors (nAChR; Slemmer et al 2000).…”

Effect of sustained-release (SR) bupropion on craving and withdrawal in smokers deprived of cigarettes for 72 h

“…The primary pharmacologic approaches recommended for smoking cessation are nicotine replacement treatments (NRTs) and sustained-release (SR) bupropion (Ferry 1999;Fiore et al 2000;Silagy et al 2004). While NRTs are substitutes for the nicotine content of cigarettes, SR bupropion (Zyban, GlaxoSmithKline) is an antidepressant with neurophysiological mechanisms that differ from the NRTs (Ferris and Cooper 1993).…”