Efficacy of bupropion for relapse prevention in smokers with and without a past history of major depression

Lisa Sanderson Cox, Christi A. Patten, Raymond S. Niaura, Paul A. Decker, Nancy Rigotti, David P.L. Sachs, A. Sonia Buist, Richard D. Hurt

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61 Scopus citations

Abstract

BACKGROUND: This study evaluated the efficacy of bupropion for relapse prevention in smokers with and without a past history of major depressive disorder. Changes in depressive symptoms were also examined. DESIGN: Data were gathered prospectively from a randomized, double-blind relapse prevention trial of bupropion conducted at five study sites. A total of 784 smokers (54% female, 97% white) were enrolled. Using the Structured Clinical Interview for Depression, 17% of the subjects reported a past history of major depressive disorder at baseline. All subjects received open-label bupropion SR (300 mg/d) for 7 weeks. Subjects abstinent from smoking at the end of 7 weeks (N = 429) were randomized to bupropion SR (300 mg/d) or placebo for the remainder of the year and followed for 1 year off medication. The primary outcome measures were median time to relapse to smoking and the 7-day point-prevalence smoking abstinence rate. Self-reported abstinence from smoking was verified by expired air carbon monoxide. The Beck Depression Inventory was used to assess depressive symptoms at baseline and at weeks 8 and 12. RESULTS: Median time to relapse did not differ by past history of major depressive disorder. Bupropion was associated with higher point-prevalence smoking abstinence at the end of medication compared to placebo (P = .007), independent of a past history of major depressive disorder. Moreover, change in depressive symptoms during the double-blind phase did not differ for those with and without a past history of major depressive disorder. CONCLUSIONS: Extended use of bupropion for relapse prevention is effective for smokers with and without a history of major depression.

Original languageEnglish (US)
Pages (from-to)828-834
Number of pages7
JournalJournal of general internal medicine
Volume19
Issue number8
DOIs
StatePublished - Aug 1 2004

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Keywords

  • Bupropion therapy
  • Major depression
  • Relapse prevention
  • Smoking

ASJC Scopus subject areas

  • Internal Medicine

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