Bupropion Added to Nicotine Replacement for Patients in Alcohol Treatment
The effectiveness of bupropion, an antidepressant approved for smoking cessation in the general population, has not been studied in people being treated for alcoholism. Therefore, researchers conducted this double-blind, placebo-controlled study of 58 patients who were beginning alcoholism treatment, smoked ≥20 cigarettes per day, were willing to quit smoking, and did not have a psychiatric condition or a contraindication to bupropion.
Subjects were randomized to receive either bupropion SR (150 mg twice per day) or placebo. Both groups received nicotine patches, were asked to attend 1 hour of smoking cessation counseling, and were instructed to start taking their pills 8 days before their planned quit day.
- Thirty-three percent of the bupropion group and 11% of the placebo group discontinued their medication by week 4.
- At each follow-up, both the bupropion and placebo groups showed a significant reduction in smoking. At week 4, 30% and 18%, respectively, reported abstinence from smoking in the past 7 days; at 6 months, the proportions were 17% and 29%, respectively.
- However, there was no significant difference in smoking abstinence between the groups.
People with alcohol or other drug use disorders have a high prevalence of smoking and much difficulty quitting. Although this study did not show a benefit of bupropion, it does suggest that using nicotine replacementwith patients in treatment for alcoholism could help them quit smoking.Julia H. Arnsten, MD, MPH
Grant K, Kelly S, Smith L, et al. Bupropion and nicotine patch as smoking cessation aids in alcoholics. Alcohol. 2007;41(5):381–391.