[Smoking cessation and bupropion: anxiety and depression as predictors of therapeutic efficacy].
Smoking and depression are related. Bupropion, the first non-nicotinic drug that is an effective treatment in smoking cessation, is a tricyclic antidepressant that inhibits neuronal uptake of serotonin, dopamine and norepinephrine in the thalamic nuclei.


OBJECTIVE
To assess if certain personality factors (anxiety or depression) might predict the efficacy of bupropion for smoking cessation.


METHODS
The study was carried out in two smoking cessation clinics in Madrid and Barcelona. Fifty patients (21 men) declaring the desire to quit smoking were enrolled. Their mean age was 43.6 years (SD 8.75). The patients were treated with 300 mg of bupropion per day for one month and expired CO was monitored for 6 months. Personality factors were assessed on a hospital anxiety and depression scale (HADS). We evaluated whether there was a significant difference in HADS scores for patients who were still not smoking after 6 months and those who had not managed to quit.


RESULTS
The 50 patients were smokers of a mean 39 packs per year (SD 17.82) and had mean scores of 7.4 (SD 4.15) for anxiety and 5.8 (SD 3.93) for depression. Four patients (8%) were unable to complete the study. After one month, 28% of the patients smoked, after 3 months 56% smoked and after 6 months 58% still smoked. The patients who smoked during the first month had higher depression scores than did the non-smokers (p = 0.03). After 3 and 6 months the patients who had managed to continue not smoking were those who had higher anxiety scores than did those who still smoked (p = 0.0052 at 3 months and p = 0.017 at 6 months).


CONCLUSIONS
Patients who responded better to treatment with bupropion after 6 months of follow-up were those with higher anxiety scores on the HADS. Depression levels influenced outcome only during the first month.
Servicio del Aparato Respiratorio, Instituto Universitario Dexeus, Barcelona, Spain. igo01m@saludalia.com
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Sampablo Lauro
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Carreras
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Lores
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Quesada
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Coll
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Sánchez Agudo
D000293:Adolescent; D000328:Adult; D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage / Q000627:therapeutic use*; D001007:Anxiety / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016642:Bupropion / Q000008:administration & dosage / Q000627:therapeutic use*; D003863:Depression / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016540:Smoking Cessation; D013997:Time Factors
D018687:Antidepressive Agents, Second-Generation; D016642:Bupropion