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Efficacy of bupropion for smoking cessation in smokers with a former history of major depression or alcoholism∗

Published online by Cambridge University Press:  02 January 2018

Kara E. Hayford
Affiliation:
Department of Psychiatry, Mayo Clinic, Rochester
Christi A. Patten*
Affiliation:
Department of Psychology, Mayo Clinic
Teresa A. Rummans
Affiliation:
Department of Psychiatry, Mayo Clinic
Darrell R. Schroeder
Affiliation:
Section of Biostatistics, Mayo Clinic
Kenneth P. Offord
Affiliation:
Section of Biostatistics, Mayo Clinic
Ivana T. Croghan
Affiliation:
Nicotine Dependence Center, Mayo Clinic
Elbert D. Glover
Affiliation:
Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV 26506
David P. L. Sachs
Affiliation:
Palo Alto Center for Pulmonary Disease Prevention, Palo Alto, CA 94301
Richard D. Hurt
Affiliation:
Nicotine Dependence Center, Mayo Clinic
*
Christi A. Patten, Nicotine Research Center, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Fax: (507) 266-7900; e-mail: patten.christi@mayo.edu

Abstract

Background

A past history of major depression or alcoholism has been associated with poorer smoking treatment outcomes.

Aim

To evaluate the efficacy of bupropion for smoking cessation in smokers with a former history of major depression or alcoholism, and changes in depressive symptoms during smoking abstinence.

Method

Data were drawn from a multicentre trial of bupropion for smoking cessation. Smokers (n=615) received placebo or bupropion sustained-release at 100, 150, or 300 mg/day for six weeks after target quit date (TQD). The primary outcome was the point prevalence smoking abstinence at the end of treatment and at one year. The Beck Depression Inventory (BDI) was used to assess depressive symptoms.

Results

A significant dose – response effect of bupropion for smoking cessation was found. This was independent of history of major depression or alcoholism. Among those continuously abstinent from smoking for two weeks following TQD, an increase in BDI score was associated with a return to smoking at end of treatment.

Conclusions

Bupropion is efficacious for smoking cessation independently of a former history of major depression or alcoholism. Increases in depressive symptoms during an initial period of abstinence are associated with a return to smoking.

Type
Papers
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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Footnotes

∗.

Presented in part at the American Psychiatric Association annual meeting, San Diego. May, 1997 and the American Society of Addiction Medicine National Conference on Nicotine Dependence, Minneapolis, October, 1997.

Declaration of interest Supported by a grant from Glaxo Wellcome Inc.

References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Ascher, J. A., Cole, J. O., Colin, J. N., et al (1995) Bupropion: A review of its mechanism of antidepressant activity. Journal of Clinical Psychiatry, 56, 395401.Google ScholarPubMed
Beck, A. T. & Steer, R. A. (1987) Manual for the Beck Depression Inventory. Washington, DC: Harcourt Brace Jovanovich.Google Scholar
Breslau, N., Peterson, E. L., Schultz, L. R., et al (1998) Major depression and stages of smoking: A longitudinal investigation. American Journal of Psychiatry, 149, 464469.Google Scholar
Covey, L. S., Glassman, A. H., Stetner, F., et al (1993) Effect of history of alcoholism or major depression on smoking cessation. American Journal of Psychiatry, 150, 15461547.Google ScholarPubMed
Dalack, G. W., Glassman, A. H., Rivelli, S., et al (1995) Mood, major depression, and fluoxetine response in cigarette smokers. American Journal of Psychiatry, 152, 398403.Google ScholarPubMed
Fagerstiöm, K. O. (1978) Measuring degree of physical dependence to tobacco smoking with reference to individualization of treatment. Addictive Behaviors, 3, 235251.CrossRefGoogle Scholar
Ginsberg, D., Hall, S. M., Reus, V. I., et al (1995) Mood and depression diagnosis in smoking cessation. Experimental and Clinical Psychopharmacology, 3, 389395.CrossRefGoogle Scholar
Glassman, A. H., Stetner, F., Walsh, B. T., et al (1988) Heavy smokers, smoking cessation, and clonidine: Results of a double-blind, randomized trial. Journal of the American Medical Association, 259, 28632866.CrossRefGoogle ScholarPubMed
Glassman, A. H., Covey, L. S., Dalack, G. W., et al (1993) Smoking cessation, Clonidine, and vulnerability to nicotine among dependent smokers. Clinical Pharmacology and Therapeutics, 54, 670679.CrossRefGoogle ScholarPubMed
Glynn, T. J. & Manley, M. W. (1987) How to Help Your Patients Stop Smoking (monograph vol. 65, pp. 7079). Washington. DC: US Department of Health and Human Services.Google Scholar
Hall, S. M., Munoz, R. & Reus, V. (1994) Cognitive-behavioral intervention increases abstinence rates for depressive history. Journal of Consulting and Clinical Psychology, 62, 141146.CrossRefGoogle ScholarPubMed
Hall, S. M., Munoz, R. & Reus, V. et al (1994) Mood management and nicotine gum in smoking treatment: A therapeutic contact and placebo-controlled study. Journal of Consulting and Clinical Psychology, 44, 10031009.Google Scholar
Hughes, J. R. (1993) Treatment of smoking cessation in smokers with past alcohol/drug problems. Journal of Substance Abuse Treatment, 10, 181187.CrossRefGoogle ScholarPubMed
Hurt, R. D., Dele, L. C., Offord, K. P., et al (1995) Nicotine patch therapy for smoking cessation in recovering alcoholics. Addiction, 90, 15411546.CrossRefGoogle ScholarPubMed
Hurt, R. D., Sachs, D. P. L., Glover, E. D., et al (1997) A comparison of sustained release bupropion and placebo for smoking cessation. New England Journal of Medicine, 337, 11951202.CrossRefGoogle ScholarPubMed
Lineberry, C. G., Johnston, J. A., Raymond, R. N., et al (1990) A fixed-dose (300 mg) efficacy study of bupropion and placebo in depressed outpatients. Journal of Clinical Psychiatry, 51, 194199.Google ScholarPubMed
Patten, C. A., Martin, J. E., Myers, M. G., et al (1991) Effectiveness of cognitive – behavioral therapy for smokers with histories of alcohol dependence and depression. Journal of Studies on Alcohol, 59, 327335.CrossRefGoogle Scholar
Schuckit, M. (1984) Genetic and clinical implications of alcoholism and affective disorder. American Journal of Psychiatry, 143, 140147.Google Scholar
Spitzer, R. L., Williams, J. B. W., Gibbon, M., et al (1990) User's Guide for the Structured Clinical Interview for DSM–III–R: SCID. Washington. DC: American Psychiatric Press.Google Scholar
Swenson, W. M. & Morse, R. M. (1975) The use of a Self-Administered Alcoholism Screening Test (SAAST) in a medical center. Mayo Clink Proceedings, 50, 204208.Google ScholarPubMed
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