Background: Bupropion SR (Zyban) has been shown in randomized controlled trials to be an efficacious pharmacological aid for smoking cessation; however, recent reports have raised serious concerns about the breadth of its applicability without complications or contraindications. Methods: We examined this issue in a well-documented medical population, i.e. veterans volunteering to participate in a smoking cessation treatment research program involving the use of bupropion SR. Results: Overall, 22% of the 78 subjects who met the study criteria were appropriate for and completed the course of medication. Conclusions: Thus, bupropion SR in nicotine-dependent veterans may not be broadly applicable when conservative prescribing guidelines are carefully followed.

Keywords:
Smoking cessation, Bupropion SR, Nicotine dependence, Contraindications
1.
Hurt RD, Sachs DP, Glover ED, Offord KP, Johnston JA, Dale LC, Khayrallah MA, Schroeder DR, Glover PN, Sullivan CR, Croghan IT, Sullivan PM: A comparison of sustained-release bupropion and placebo for smoking cessation. N Engl J Med 1997;337:1195–1202.
2.
Hughes JR, Goldstein MG, Hurt RD, Shiffman S: Recent advances in the pharmocotherapy of smoking. JAMA 1999;281:72–76.
3.
Fiore MC, Bailey WC, Cohen SJ, et al: Treating Tobacco Use and Dependence. Clinical Practice Guideline. Rockville, US Department of Health and Human Services, Public Health Service, 2000.
4.
The Department of Health, Social Services and Public Safety: Safety of Zyban as an aid to smoking cessation. July, 2001. http://www.dhsspsni.gov.uk/publications/archived/2001/CMO19.pdf
5.
Committee on Safety of Medicines: Current problems in pharmacovigilance. August, 2001, vol 27. http://www.mca.gov.uk/ourwork/monitorsafequalmed/currentproblems/cpprevious.htm
6.
Dunlop H: Canadian Adverse Drug Reaction Newsletter. 2000, vol 10, No 1, pp 3–5.
7.
Gifford EV, Kohlenberg BS, Piasecki M, Palm K, Antonuccio D, Hayes SC: Bupropion SR in combination with acceptance based behavioral therapy for smoking cessation: Results from a randomized clinical trial. 36th Annu Assoc Adv Behav Ther, Reno, 2002.
8.
Seligman ME: The effectiveness of psychotherapy. The Consumer Reports Study. Am Psychol 1995;50:965–974.
9.
Stricker G: The relationship between efficacy and effectiveness. Prev Treat 2000;3:10. http:// www.journals.apa.org/prevention/volume3/pre0030010c.html
10.
Faravelli C, Cosci F, Ciampelli M, Scarpato MA, Spiti R, Ricca V: A self-controlled, naturalistic study of selective serotonin reuptake inhibitors versus tricyclic antidepressants. Psychother Psychosom 2003;72:95–101.
11.
Melander H, Ahlqvist-Rastad J, Meijer G, Beermann B: Evidence based medicine – Selective reporting from studies sponsored by the pharmaceutical industry: Review of studies in new drug applications. BMJ 2003;326:1171–1173.
12.
Fava G: Long-term treatment with antidepressant drugs: The spectacular effects of propaganda. Psychother Psychosom 2002;71:127–132.
© 2004 S. Karger AG, Basel
2004
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.