The use of bupropion SR in cigarette smoking cessation.
Cigarette smoking remains the largest preventable cause of premature death in developed countries. Until recently nicotine replacement therapy (NRT) has been the only recognised form of treatment for smoking cessation. Bupropion, the first non-nicotine based drug for smoking cessation was licensed in the United States of America (US) in 1997 and in the United Kingdom (UK) in 2000 for smoking cessation in people aged 18 years and over. Bupropion exerts its effect primarily through the inhibition of dopamine reuptake into neuronal synaptic vesicles. It is also a weak noradrenalin reuptake inhibitor and has no effect on the serotonin system. Bupropion has proven efficacy for smoking cessation in a number of clinical trials, helping approximately one in five smokers to stop smoking. Up to a half of patients taking bupropion experience side effects, mainly insomnia and a dry mouth, which are closely linked to the nicotine withdrawal syndrome. Bupropion is rarely associated with seizures however care must be taken when co-prescribing with drugs that can lower seizure threshold. Also, bupropion is a potent enzyme inhibitor and can raise plasma levels of some drugs including antidepressants, antiarrhythmics and antipsychotics. Bupropion has been shown to be a safe and cost effective smoking cessation agent. Despite this, NRT remains the dominant pharmacotherapy to aid smoking cessation.
Wilkes
Scott
S
Department of Primary and Community Care, School of Health, Natural and Social Sciences, University of Sunderland, Sunderland, United Kingdom. scott.wilkes@sunderland.ac.uk
D016642:Bupropion / Q000191:economics / Q000494:pharmacology* / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D003692:Delayed-Action Preparations; D018765:Dopamine Uptake Inhibitors / Q000191:economics / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D016540:Smoking Cessation; D014029:Tobacco Use Disorder / Q000188:drug therapy*; D016896:Treatment Outcome
D003692:Delayed-Action Preparations; D018765:Dopamine Uptake Inhibitors; D016642:Bupropion