title: Effect of bupropion on depression symptoms in a smoking cessation clinical trial.
abstract: Bupropion is an antidepressant shown to be efficacious for smoking cessation. This study examined the short- and long-term effects of bupropion (300 mg/day for 10 weeks) versus placebo on depression symptoms among 497 smokers attempting to quit in a randomized trial of bupropion plus behavioral counseling. Depression symptoms were assessed via the Center for Epidemiological Studies Depression Scale (L. Radloff, 1977) at baseline, end of treatment, and at 6-month follow-up. Baseline nicotine dependence level was assessed with the Fagerström Test for Nicotine Dependence (T. F. Heatherton, L. T. Kozlowski, R. C. Frecker, & K. O. Fagerstrom, 1991). A regression model of depression symptoms demonstrated a significant interaction between nicotine dependence and treatment for the treatment phase and during follow-up. Depression symptoms did not mediate the effects of bupropion on abstinence at either time point. Highly nicotine-dependent smokers who receive bupropion are more likely to experience a decrease in depressive symptoms during active treatment but are also more likely to experience a rebound in depressive symptoms when bupropion is discontinued.
authors.affiliation: Department of Psychiatry, Abramson Family Cancer Research Institute, University of Pennsylvania Cancer Center, Philadelphia, PA, USA. clerman@mail.med.upenn.edu
authors.forename: Caryn
authors.initials: C
authors.lastname: Lerman
authors.forename: Ray
authors.initials: R
authors.lastname: Niaura
authors.forename: Bradley N
authors.initials: BN
authors.lastname: Collins
authors.forename: Paul
authors.initials: P
authors.lastname: Wileyto
authors.forename: Janet
authors.initials: J
authors.lastname: Audrain-McGovern
authors.forename: Angela
authors.initials: A
authors.lastname: Pinto
authors.forename: Larry
authors.initials: L
authors.lastname: Hawk
authors.forename: Leonard H
authors.initials: LH
authors.lastname: Epstein
mesh_terms: D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D016642:Bupropion / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000188:drug therapy*; D037001:Directive Counseling; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology
chemical_list: D018687:Antidepressive Agents, Second-Generation; D016642:Bupropion