Bupropion and Patch Help 19% at One Year: Higher success rates than reported elsewhere were in 1^st New England Journal of Medicine Study. Abstinence rates at 12 months were 15.6% in the placebo group, as compared with 16.4% in the nicotine-patch group, 30.3% in the bupropion group (P<0.001), and 35.5% in the group given bupropion and the nicotine patch (P<0.001). U Wisc. A controlled trial of sustained-release bupropion, a nicotine patch, or both for smoking cessation. Jorenby DE, Leischow SJ, Nides MA, Rennard SI, Johnston JA, Hughes AR, Smith SS, Muramoto ML, Daughton DM, Doan K, Fiore MC, Baker TB., N Engl J Med 1999 Mar 4;340(9):685-91

Bupropion 10% Benefit at One Year: In a DB PC study of 707 Danish smokers, the 527 assigned to bupropion SR 150 twice a day had a 21% rate of continuous abstinence at one year vs. 11% for the placebo group. Adverse events were higher for the bupropion SR group compared with placebo (insomnia 24% vs. 15%; dry mouth 13% vs. 5%). A multicentre, randomized, double-blind, placebo-controlled, 1-year study of bupropion SR for smoking cessation. Tonnesen P, Tonstad S, Hjalmarson A, Lebargy F, Van Spiegel PI, Hider A, Sweet R, Townsend J. J Intern Med. 2003 Aug;254(2):184-92. 

Bupropion = Nortriptyline = Placebo: No Difference (0%) on Tobacco Abstinence at One Year: A study of medical management vs. psychological intervention had smokers taking either bupropion, nortriptyline or placebo and either getting psychological treatment or not in a randomized trial. Participants were 220 cigarette smokers. Outcome measures were biologically verified abstinence from cigarettes at weeks 12, 24, 36, and 52. Neither medication nor psychological intervention had a measurable impact at 1 year. UCSF, Psychological intervention and antidepressant treatment in smoking cessation. Hall SM, Humfleet GL, Reus VI, Munoz RF, Hartz DT, Maude-Griffin R. Arch Gen Psychiatry 2002 Oct;59(10):930-6

Bupropion, Nortriptyline, and Other Anti-Depressants: In a review of all well-controlled studies using anti-depressants to treat nicotine dependence, there was one trial each of moclobemide, sertraline and venlafaxine, two of fluoxetine, five of nortriptyline, and twenty trials of bupropion. In the bupropion trials, 18 had a placebo arm, two of which tested long-term use to prevent relapse. Nine of the bupropion trials have been published in full. Nortriptyline (five trials, OR 2.80) and bupropion (16 trials, OR 1.97) both increased the odds of cessation. In one trial the combination of bupropion and nicotine patch produced slightly higher quit rates than patch alone, but this was not replicated in a second study. Two trials of extended therapy with bupropion to prevent relapse after initial cessation have failed to detect a long-term benefit. Univ. Vermont. Antidepressants for smoking cessation. Hughes JR, Stead LF, Lancaster T. Cochrane Database Syst Rev. 2003;(2):CD000031

Bupropion 4% Benefit at One Year: abstinence rates between men (61.8%) and women (55.6%) in open-label bupropion (Week 7) were not significant. In the RP-phase Week 52, continuous abstinence rates for men and women were 37.8% and 36.4% (bupropion) and 36.6% and 29.9% (placebo), respectively; point-prevalence abstinence rates for men and women were 54.1% and 55.9% (bupropion) and 42.9% and 41.3% (placebo), respectively. 432 in study. Effects of gender on relapse prevention in smokers treated with bupropion SR. Gonzales D, Bjornson W, Durcan MJ, White JD, Johnston JA, Buist AS, Sachs DP, Rigotti NA, Niaura R, Hays JT, Hurt RD. Am J Prev Med 2002 May;22(4):234-9

Bupropion 11% Benefit at 6 Months: In a DB PC Danish study of hospital workers smoking at least 10 cigarette a day, after 26 weeks, 18% on bupropion and 7% on placebo were continuously abstinent, p=.008. Side-effects were frequent but simple and reversible in both groups. Dizziness, insomnia, and pruritus appeared more frequently with bupropion. A multicenter, randomized, double-blind, placebo-controlled, 6-month trial of bupropion hydrochloride sustained-release tablets as an aid to smoking cessation in hospital employees. Dalsgareth OJ, Hansen NC, Soes-Petersen U, Evald T, Hoegholm A, Barber J, Vestbo J. Nicotine Tob Res. 2004 Feb;6(1):55-61

Bupropion Helps Stop Smoking for 15% at Six Months: In a DB PC study of 509 smokers motivated to quit smoking, those on bupropion 150 mg b.i.d. for 7 weeks, and followed-up for 26 weeks showed a six months' point abstinence rate were 31% vs.  16%. Craving decreased significantly more with bupropion, but there was no difference for total withdrawal symptoms score. Low level of nicotine dependence, high motivation, absence of smoking-related disease, long duration of previous quit attempts, male gender, low level of current alcohol problems and living as a couple were predictive of successful cessation. Efficacy of bupropion and predictors of successful outcome in a sample of French smokers: a randomized placebo-controlled trial. Aubin HJ, Lebargy F, Berlin I, Bidaut-Mazel C, Chemali-Hudry J, Lagrue G. Limeil-Brevannes, France. Addiction. 2004 Sep;99(9):1206-18. 

Bupropion Did Help Tobacco Abstinence at One Year: Smokers (N= 784) who were interested in stopping smoking were enrolled in a 7-week, open-label bupropion phase. Abstinent subjects at the end of treatment and eligible to proceed (N= 429) were randomized to active bupropion or placebo through Week 52 and then followed for an additional year. The best overall predictor of less relapse to smoking was assignment to active bupropion. Bupropion for pharmacologic relapse prevention to smoking: predictors of outcome. Hurt RD, Wolter TD, Rigotti N, Hays JT, Niaura R, Durcan MJ, Gonzales D, Sachs DP, Johnston JA, Offord KP. Addict Behav 2002 Jul-Aug;27(4):493-507; Same study as above?

Bupropion Helps 9% with 1 Year Tobacco Abstinence: At month 12, abstinence rates were 10% with bupropion SR, 7% combination bupropion plus nicotine, 2% nicotine patch, and 1% placebo. DB PC 893 pt. Late-term smoking cessation despite initial failure: an evaluation of bupropion sustained release, nicotine patch, combination therapy, and placebo. Jamerson BD, Nides M, Jorenby DE, Donahue R, Garrett P, Johnston JA, Fiore MC, Rennard SI, Leischow SJ. Clin Ther 2001 May;23(5):744-52; funded by Glaxo, the manufacturer of bupropion SR.

Bupropion Reduces Craving: Bupropion SR appears to reduce reported cravings, which may contribute to the overall reduction in the rate of relapse observed with this pharmacotherapy. The effect of bupropion sustained-release on cigarette craving after smoking cessation. Durcan MJ, Deener G, White J, Johnston JA, Gonzales D, Niaura R, Rigotti N, Sachs DP. Clin Ther 2002 Apr;24(4):540-51

Bupropion Helps 7% With 6 Month Abstinence in Afro-Americans: 26 weeks the quit rates were 21.0% in the treatment and 13.7% in the placebo groups (7.3% difference, P =.02). Those taking bupropion SR experienced a greater mean reduction in depression symptoms at week 6 (2.96 vs. 1.13) than those taking placebo, and after controlling for continuous abstinence, those taking bupropion SR also gained less weight. Sustained-release bupropion for smoking cessation in African Americans: a randomized controlled trial. Ahluwalia JS, Harris KJ, Catley D, Okuyemi KS, Mayo MS. JAMA 2002 Jul 24-31;288(4):468-74

Bupropion and Nicotine Patches Claimed Very Cost-Effective for Tobacco: The results of the decision analyses indicated that, as compared with advice or counseling alone, the incremental cost per life-years saved is about $1,441-$3,455 for Nicotine Replacement Therapy (NRT), $920-$2,150 for bupropion SR, and $1,282-$2,836 for NRT plus bupropion SR. The cost-effectiveness of adding NRT and bupropion SR to advice or counseling for smoking cessation is better than many other accepted health care interventions. Cost-effectiveness of pharmacological interventions for smoking cessation: a literature review and a decision analytic analysis. Song F, Raftery J, Aveyard P, Hyde C, Barton P, Woolacott N. Med Decis Making 2002 Sep-Oct;22(5 Suppl):S26-37 Ed: The above 1 year studies are not impressive. Also, there are no studies for more than one year.  It would be nice to know what the relapse rate is once the bupropion is discontinued.  There is simply not enough data from which to make the calculations of long-term cost-effectiveness. I am not impressed.

Helped Smokeless Tobacco Addiction in 7 Week Study: A comparison of sustained-release bupropion and placebo for smokeless tobacco cessation. Glover ED, Glover PN, Sullivan CR, Cerullo CL, Hobbs G. Am J Health Behav 2002 Sep-Oct;26(5):386-93; Similar 12 week DB PC study with 68 adults, At the end of 12 weeks of therapy, the point-prevalence tobacco abstinence rate was 44% in the bupropion group and 26% in the placebo group. Bupropion for the treatment of nicotine dependence in spit tobacco users: a pilot study. Dale LC, Ebbert JO, Schroeder DR, Croghan IT, Rasmussen DF, Trautman JA, Cox LS, Hurt RD. Nicotine Tob Res 2002 Aug;4(3):267-74

Helped Tobacco Addiction in Schizophrenia in 1 Week Study: DB PC 32 pt. Bupropion significantly increased trial endpoint 7-day point prevalence smoking abstinence rates compared with placebo [BUP, 8/16 (50.0%), PLA, 2/16 (12.5%); chi(2) = 5.24, df = 1, p <.05], and reduced CO levels during the trial [Medication x Time interaction; Z = 3.09, p <.01]. Positive schizophrenia symptoms were not altered by BUP, but negative symptoms were significantly reduced. Atypical antipsychotic drug treatment enhanced smoking cessation responses to BUP. Major side effects were dry mouth, gastrointestinal symptoms, headache, and insomnia. A placebo controlled trial of bupropion for smoking cessation in schizophrenia. George TP, Vessicchio JC, Termine A, Bregartner TA, Feingold A, Rounsaville BJ, Kosten TR. Biol Psychiatry 2002 Jul 1;52(1):53-61

May Help Tobacco Addition in Schizophrenia: 3-month, double-blind, placebo-controlled trial of bupropion SR, 150 mg/day, added to a concurrent CBT program with 3-month follow-up in 19 stable outpatients with schizophrenia who wanted to quit smoking. Eighteen subjects completed the trial. Bupropion treatment was associated with significantly greater reduction in smoking, as measured by self-report verified by expired-air carbon monoxide (6/9 subjects, 66%), than placebo (1/9 subjects, 11%) during the 3-month active treatment period and the 3-month follow-up period. One subject in the bupropion group (11%) and no subjects in the placebo group achieved sustained tobacco abstinence for the 6-month trial. Bupropion treatment was associated with improvement in negative symptoms and greater stability of psychotic and depressive symptoms. MGH, A pilot trial of bupropion added to cognitive behavioral therapy for smoking cessation in schizophrenia. Evins AE, Mays VK, Rigotti NA, Tisdale T, Cather C, Goff DC. Nicotine Tob Res 2001 Nov;3(4):397-403

Patches & Bupropion May Help: Mailed survey to 3000+ health plan members. Nearly half (1,513) of these smokers reported a quit attempt during the preceding 6 months. Although 1,036 (33.2%) reported using some type of aid to quitting, primarily nicotine products or bupropion, 10-26% of these "users" did not report an actual quit attempt. Ninety percent of the medication users had a personal cost, averaging $53-$87. Fully 26.9% of those reporting a quit without any type of aid quit for at least 7 days. This rate equals that of users of all types of aids except for nicotine patches and bupropion, both of which had associated 7 or more day quit rates of about 46%. Aids to quitting tobacco use: how important are they outside controlled trials? Solberg LI, Boyle RG, Davidson G, Magnan S, Link Carlson C, Alesci NL.

Bupropion SR Delays Tobacco Relapse: 784 smokers rx 300mg/d 7 weeks with 60% abstinent. Those 429 randomized PC DB. One year relapse 55% vs. 42%. Those randomized and again 48% vs. 38% relapsed with bupropion lower. Then, all d/c. At two years, 60% each group relapsed, but time to relapse 156 days vs. 65 days.

Helped Smokeless Tobacco Addiction in 7 Week Study: A comparison of sustained-release bupropion and placebo for smokeless tobacco cessation. Glover ED, Glover PN, Sullivan CR, Cerullo CL, Hobbs G. Am J Health Behav 2002 Sep-Oct;26(5):386-93; Similar 12 week DB PC study with 68 adults, At the end of 12 weeks of therapy, the point-prevalence tobacco abstinence rate was 44% in the bupropion group and 26% in the placebo group. Bupropion for the treatment of nicotine dependence in spit tobacco users: a pilot study. Dale LC, Ebbert JO, Schroeder DR, Croghan IT, Rasmussen DF, Trautman JA, Cox LS, Hurt RD. Nicotine Tob Res 2002 Aug;4(3):267-74

Helped Tobacco Addiction in Schizophrenia in 1 Week Study: DB PC 32 pt. Bupropion significantly increased trial endpoint 7-day point prevalence smoking abstinence rates compared with placebo [BUP, 8/16 (50.0%), PLA, 2/16 (12.5%); chi(2) = 5.24, df = 1, p <.05], and reduced CO levels during the trial [Medication x Time interaction; Z = 3.09, p <.01]. Positive schizophrenia symptoms were not altered by BUP, but negative symptoms were significantly reduced. Atypical antipsychotic drug treatment enhanced smoking cessation responses to BUP. Major side effects were dry mouth, gastrointestinal symptoms, headache, and insomnia. A placebo controlled trial of bupropion for smoking cessation in schizophrenia. George TP, Vessicchio JC, Termine A, Bregartner TA, Feingold A, Rounsaville BJ, Kosten TR. Biol Psychiatry 2002 Jul 1;52(1):53-61 

Bupropion May Help Atopic Dermatitis and Psoriasis: Open trial 150 x 3 weeks to 300 x 3 weeks helps 6 of 10 atopic and 8 of 10 psoriasis patients with 50% improvement in area covered with relapse on d/c of med. Treatment of atopic dermatitis and psoriasis vulgaris with bupropion-SR: a pilot study. Modell JG, Boyce S, Taylor E, Katholi C. Psychosom Med 2002 Sep-Oct;64(5):835-40