Efficacy of bupropion for relapse prevention in smokers with and without a past history of major depression.
BACKGROUND
This study evaluated the efficacy of bupropion for relapse prevention in smokers with and without a past history of major depressive disorder. Changes in depressive symptoms were also examined.


METHODS
Data were gathered prospectively from a randomized, double-blind relapse prevention trial of bupropion conducted at five study sites. A total of 784 smokers (54% female, 97% white) were enrolled. Using the Structured Clinical Interview for Depression, 17% of the subjects reported a past history of major depressive disorder at baseline. All subjects received open-label bupropion SR (300 mg/d) for 7 weeks. Subjects abstinent from smoking at the end of 7 weeks (N = 429) were randomized to bupropion SR (300 mg/d) or placebo for the remainder of the year and followed for 1 year off medication. The primary outcome measures were median time to relapse to smoking and the 7-day point-prevalence smoking abstinence rate. Self-reported abstinence from smoking was verified by expired air carbon monoxide. The Beck Depression Inventory was used to assess depressive symptoms at baseline and at weeks 8 and 12.


RESULTS
Median time to relapse did not differ by past history of major depressive disorder. Bupropion was associated with higher point-prevalence smoking abstinence at the end of medication compared to placebo (P = .007), independent of a past history of major depressive disorder. Moreover, change in depressive symptoms during the double-blind phase did not differ for those with and without a past history of major depressive disorder.


CONCLUSIONS
Extended use of bupropion for relapse prevention is effective for smokers with and without a history of major depression.
Cox
Lisa Sanderson
LS
Nicotine Dependence Center Research Program, Mayo Clinic, Rochester, Minnesota 55905, USA.
Patten
Christi A
CA
Niaura
Raymond S
RS
Decker
Paul A
PA
Rigotti
Nancy
N
Sachs
David P L
DP
Buist
A Sonia
AS
Hurt
Richard D
RD
D000328:Adult; D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D016642:Bupropion / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000523:psychology*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055502:Secondary Prevention; D012907:Smoking / Q000523:psychology; D016540:Smoking Cessation / Q000523:psychology*; D000074606:Smoking Prevention; D016896:Treatment Outcome
D018687:Antidepressive Agents, Second-Generation; D016642:Bupropion