Bupropion and tobacco cravings

Bupropion hydrochloride was originally marketed as an antidepressant but it has also been found to be effective in helping people to give up smoking. It reduces people's cravings for cigarettes but noone knows quite how it works. A team of researchers from the University of California Los Angeles studied 30 people all of whom were hooked on cigarettes. Over an eight-week study half of them were given bupropion and half were given a placebo. The participants who had been given bupropion reported fewer cravings and less activation in the left ventral striatum, the right medial orbitofrontal cortex and the bilateral anterior cingulate cortex than those who were taking a placebo. All the participants showed reduced brain activity in the bilateral medial orbitofrontal cortex and the left anterior cingulate cortex when they were trying to resist tobacco cravings suggesting that bupropion works by dampening down these areas of the brain.

Culbertson, Christopher S. ... [et al] - Effect of Bupropion Treatment on Brain Activation Induced by Cigarette-Related Cues in Smokers Archives of General Psychiatry doi:10.1001/archgenpsychiatry.2010.193

Combination therapy more effective for depression

Between 50% and 75% of people show some improvement on first taking an antidepressant but only about a third completely recover after taking just one drug. Previous research has shown that a combination of drugs can have a better effect and a team of researchers led by Pierre Blier of the University of Ottawa studied the effectiveness of adding mirtazapine to various different antidepressants. Mirtazapine belongs to a different class of drugs to most other antidepressants and is classified as a noradrenergic and specific serotonergic antidepressant (NaSSA). 105 people with major depression received either fluoxetine on its own, or mirtazapine combined with fluoxetine, venlafaxine or bupropion. The recovery rates were 25% for fluoxetine, 52% for mirtazapine and fluoxetine, 58% for mirtazapine and venlafaxine and 46% for mirtazapine and bupropion. There were no extra side effects from using a combination of different drugs.

Blier, Pierre ... [et al] - Combination of antidepressant medications from treatment initiation for major depressive disorder: a double-blind randomized study American Journal of Psychiatry March 2010, 167(3), 281-288

Bupropion helps pregnant smokers

Smoking while pregnant can cause damage to unborn children and depression is also associated with 'adverse maternal and neonatal outcomes.' Both are common in pregnant women who use illegal drugs. Researchers from John Hopkins University in Baltimore studied 56 women who were enrolled in a drug-treatment programme which combined a week-long residential stay with follow-up outpatient treatment. Some were given bupropion, others were given citalopram or escitalopram and others were given no antidepressants. The women who took bupropion cut down their cigarette smoking by an average of 6.4 cigarettes a day (compared to negligible changes in the other groups) and were much more likely to show an improvement in their depression.

You can find out more about this research at

http://uk.reuters.com/article/healthNews/idUKTRE53S7UD20090429?feedType=RSS&feedName=healthNews&sp=true