title: Efficacy of bupropion for relapse prevention in smokers with and without a past history of major depression.
abstract: 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.
authors.affiliation: Nicotine Dependence Center Research Program, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: Lisa Sanderson
authors.initials: LS
authors.lastname: Cox
authors.forename: Christi A
authors.initials: CA
authors.lastname: Patten
authors.forename: Raymond S
authors.initials: RS
authors.lastname: Niaura
authors.forename: Paul A
authors.initials: PA
authors.lastname: Decker
authors.forename: Nancy
authors.initials: N
authors.lastname: Rigotti
authors.forename: David P L
authors.initials: DP
authors.lastname: Sachs
authors.forename: A Sonia
authors.initials: AS
authors.lastname: Buist
authors.forename: Richard D
authors.initials: RD
authors.lastname: Hurt
mesh_terms: 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
chemical_list: D018687:Antidepressive Agents, Second-Generation; D016642:Bupropion