Sep. 20, 2001 ROCHESTER, MINN. -- Smokers who stop smoking by taking the antidepressant bupropion (Zyban™) used to treat nicotine addiction are less likely to relapse if they use the medication for one year, according to a Mayo Clinic study published in the September 18 issue of Annals of Internal Medicine.
Despite treatment advances to help people stop smoking, 70 to 80 percent of smokers who stop relapse within six to 12 months. This is the first long-term, multi-center study to evaluate the use of the antidepressant bupropion to prevent relapse.
Centers involved in the study were Mayo Clinic in Rochester, Minn.; Palo Alto Center for Pulmonary Disease Prevention, Palo Alto, Calif.; Brown University, Providence, R.I.; Oregon Health Sciences University, Portland, Ore.; and Massachusetts General Hospital, Boston, Mass.
How the study was done
In the study, 784 participants took bupropion to help them stop smoking. After seven weeks of bupropion treatment, 461 participants had successfully stopped. Half of that group continued with bupropion for a year, and the other half took a placebo.
At year’s end, 55 percent of the group continuing to take bupropion were abstinent vs. 42 percent in the placebo group.
"That’s a significant and encouraging difference," says J. Taylor Hays, M.D., associate medical director of the Mayo Clinic Nicotine Dependence Center and lead investigator in the study.
However, at the two-year follow-up, the abstinence rates were nearly the same for both groups, about 40 percent. "These results show that longer term use of bupropion can help prevent smoking relapse. But we don’t know yet how long people should take it to be most effective."
Another benefit: less weight gain
Researchers also found participants taking bupropion gained less weight than those on the placebo. Those individuals taking bupropion gained an average of seven pounds less compared with individuals on placebo at the end of one year of treatment. "Weight gain is a common concern for people trying to stop smoking," says Dr. Hays. "Bupropion seems to make weight management a little easier."
Bupropion, which has been on the market for many years, is the first non-nicotine medication that has been proven to be effective in treating nicotine addiction. It is believed to mimic some of the action of nicotine by increasing the brain chemicals dopamine and norepinephrine. It is normally used for seven to 12 weeks as part of treatment to stop smoking. For most people, there are few or minor side effects.
Dr. Hays says people who are trying to quit smoking should ask their physician about longer-term use of bupropion to help prevent relapse.
"Bupropion could be the difference that helps people stay smoke-free, especially for people at higher risk for relapse such as those who live with another smoker or have had several failed attempts at quitting," he says.
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