Efficacy and safety of bupropion for smoking cessation and reduction in schizophrenia: systematic review and meta-analysis.
BACKGROUND
The benefits and harms of bupropion as an aid for smoking cessation in schizophrenia remain uncertain.


OBJECTIVE
To summarise the current evidence for efficacy and safety of bupropion as treatment for nicotine dependence in schizophrenia.


METHODS
Systematic review and random-effects meta-analysis of randomised controlled trials (RCTs) comparing bupropion with placebo or alternative therapeutic control in adult smokers with schizophrenia.


RESULTS
Twenty-one reports from seven RCTs were included. Biochemically verified self-reported smoking cessation rates after bupropion were significantly higher than placebo at the end of treatment (risk ratio (RR) = 2.57, P = 0.004) and at 6 months (RR = 2.78, P = 0.05). Expired carbon monoxide level was significantly lower with bupropion at the end of therapy (P = 0.002) but not at 6 months (P = 0.37). There was no significant difference in positive (P = 0.28) or negative symptoms (P = 0.49) between the bupropion and the placebo group.


CONCLUSIONS
Bupropion increases the rates of smoking abstinence in smokers with schizophrenia, without jeopardising their mental state.
Tsoi
Daniel Tai-yin
DT
Academic Clinical Psychiatry, University of Sheffield, Sheffield, UK. t.tsoi@sheffield.ac.uk
Porwal
Mamta
M
Webster
Angela Claire
AC
D000328:Adult; D016642:Bupropion / Q000009:adverse effects / Q000627:therapeutic use*; D017831:Diagnosis, Dual (Psychiatry); D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012565:Schizophrenic Psychology; D016540:Smoking Cessation / Q000379:methods*; D014029:Tobacco Use Disorder / Q000534:rehabilitation*; D016896:Treatment Outcome
D016642:Bupropion