The use of the antidepressant, sustained release (SR) bupropion, triples quit rates among women and smokers with a history of depression as compared to placebo, according to a new study just published in Nicotine and Tobacco Research by researchers at the Center for Tobacco Research and Intervention. Historically, women and formerly depressed smokers are at particularly high risk of relapse. From the University of Wisconsin, Madison:
Study shows promise for smokers trying to quit
The use of the antidepressant, sustained release (SR) bupropion, triples quit rates among women and smokers with a history of depression as compared to placebo, according to a new study just published in Nicotine and Tobacco Research by researchers at the Center for Tobacco Research and Intervention. Historically, women and formerly depressed smokers are at particularly high risk of relapse.
Previous research has shown that women tend to report more negative mood during withdrawal and are more prone to relapse than men. In this study, bupropion considerably improved women’s mood and abstinence rates. About 25 percent of the women who had taken bupropion SR were still abstaining a year later, triple the 8.5 percent success for those using a placebo tablet. The women on the placebo pill reported more negative mood than the men in that group, but no gender differences were observed for smokers using bupropion SR.
A similar effect was noted for smokers with a previous history of depression. Bupropion SR significantly improved their abstinence rates. Less than 10 percent of smokers with a history of depression on placebo pills were still abstaining at the end of the treatment, compared to 17 percent of those who had not been depressed. That difference was erased for those taking the active medication, with about 30 percent abstaining in both groups.
Lead author, Stevens Smith, Ph.D., of the UW Center, said, “In effect, bupropion appears to equalize the disparity between quit rates of women and men. This also appears to be true for previously depressed smokers and those without a history of depression.”
Smith and his colleagues conducted a secondary analysis of a clinical trial of 893 smokers randomized to four groups: two treated for eight weeks with bupropion SR tablets (one coupled with nicotine patches, one with placebo patches), and two treated with placebo tablets (again, one with nicotine patches, one with placebo patches). The nicotine patch did not significantly improve quitting for either group.
Although their trial results suggest that women and depressed smokers trying to quit should be encouraged to take bupropion SR, “there is considerable debate about how bupropion and other antidepressants produce clinical benefit in depression,” said Smith. For this reason, the authors caution that “further research is needed to replicate the findings.”
Abstinence rates among those treated with both the active pill and active patch were not significantly higher than rates produced by the antidepressant alone, although the authors note that they were sufficiently better to warrant further research.
The study was funded by Glaxo Wellcome, Inc. (now GlaxoSmithKline), a pharmaceutical company that markets bupropion SR under the brand name Zyban.
The Center for Tobacco Research and Intervention, a program of the University of Wisconsin Medical School, has provided cessation and prevention services in Wisconsin since 1992 and is a nationally-recognized research center.
