Smoking Cessation Drugs: Bupropion

by Karen Schroeder Kassel, MS, RD, MEd

Type of Medication

  • Antidepressant

Commonly Used Brand Names    TOP

  • Wellbutrin
  • Zyban

What Bupropion Is Prescribed For    TOP

Bupropion is an antidepressant, but it is also prescribed to help people quit smoking. It can be used in combination with a nicotine replacement product.

How Bupropion Works

Bupropion appears to affect two brain chemicals that may be related to nicotine addiction: dopamine and norepinephrine. Bupropion reduces the cravings for cigarettes that smokers experience when they try to quit. It also seems to reduce many of the nicotine withdrawal symptoms, such as irritability, frustration, and anger.

Considerations While Taking This Medication    TOP

See Your Doctor

Your doctor will determine the appropriate level of bupropion for you and will adjust the dosage as you progress.

Manage Your Medications

Tell your doctor about all the medicines you take. Some should not be taken with bupropion. For example, you should not take bupropion for smoking cessation if you:

  • Are already taking another drug that also contains bupropion
  • Have used a monoamine oxidase inhibitors (MAOIs), another type of antidepressant, in the past 14 days

Be Cautious With Certain Conditions

Certain conditions can affect whether it is safe for you to take bupropion. Tell your doctor about your medical history and if you have any health problems, especially if you have:

Other conditions that are important to let your doctor know about include:

If you are woman who is pregnant or breastfeeding, be sure to talk to your doctor about whether it is safe for you to take bupropion.

Proper Usage    TOP

Start taking bupropion 1-2 weeks before you plan to stop smoking. This will give the medicine enough time to reach adequate levels in your body.

Note : Do not double dose. Taking too much bupropion at one time can cause serious reactions, including seizures.

If all goes well and you are successful in quitting, you should plan to stay on the bupropion for 7-12 weeks. Your doctor may recommend a longer course of treatment, however, depending on your circumstances.

Possible Side Effects    TOP

Most people do not have side effects from taking bupropion for smoking cessation. If side effects do occur, they can usually be minimized. In addition, side effects are most often temporary, lasting only as long as you are taking the medicine.

There are rare, but serious side effects that you should be aware of. Medicines like bupropion may cause severe mood and behavior changes in some people, including suicidal thoughts. Young adults may be more at risk for these side effects. Make sure you call your doctor right away if this happens to you.

Other Side Effects

You should also call your doctor right away if any of the following occur:

  • Seizure
  • Anxiety
  • Difficulty thinking clearly
  • Buzzing or ringing in ears
  • Severe headache
  • Allergic reaction (eg, skin rash, hives)

If these side effects occur frequently and/or become bothersome, call your doctor:

Symptoms of an Overdose

Symptoms of an overdose may be more severe than side effects seen at regular doses, or two or more side effects may occur together. Call your doctor right away if you notice any of the following:

  • Fast heartbeat
  • Hallucinations
  • Loss of consciousness
  • Nausea and/or vomiting
  • Seizures

Drug Interactions    TOP

Combining bupropion with other medicines can increase your risk of seizures, as well as other potentially dangerous interactions. Examples of medicines that can cause problems include:

  • Antidepressants
  • MAOIs
  • Antipsychotic medicines
  • Anti-arrhythmic agents
  • Beta-blockers
  • Benzodiazepines
  • Corticosteroids
  • Theophylline

There are many other medicines that may interact with bupropion. Be sure to discuss any other medicines that you are taking with your doctor.

Smoking Cessation Success    TOP

It is very clear from all of the studies on smoking cessation that your chance of long-term success depends a great deal on your motivation and commitment to quitting, regardless of which therapy you choose.

RESOURCES:

American Lung Association
http://www.lungusa.org
Smokefree.gov
http://www.smokefree.gov/

CANADIAN RESOURCES:

Canadian Cancer Society
http://www.cancer.ca/
Canadian Lung Association
http://www.lung.ca

References:

Bupropion. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated April 11, 2011. Accessed June 20, 2012.
Bupropion for smoking cessation. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated June 19, 2012. Accessed June 20, 2012.
Lexi-PALS. Bupropion. EBSCO Health Library, Lexi-PALS website. Available at: http://www.ebscohost.com/healthLibrary/. Updated November 5, 2010. Accessed June 20, 2012.
Respiratory Health Association. Prescription medicine: bupropion (Wellbutrin SR, Zyban). Take Control of Your Health website. Available at: http://www.tcyh.org/smoking/downloads/rha/Bupropion.pdf. Accessed June 20, 2012.
Roddy E. Bupropion and other non-nicotine pharmocotherapies. BMJ. 2004; 328(7438): 509-511.
Tobacco use cessation. Agency for Healthcare Research and Quality website. Available at: http://www.guideline.gov/syntheses/synthesis.aspx?id=35231. Updated February 2012. Accessed June 20, 2012.
Last reviewed June 2012 by Brian Randall, MD
Last Updated: 6/20/2012
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