United Kingdom - Bupropion, (Zyban®) the first non-nicotine prescription medicine for use as an aid to smoking cessation has been launched. It acts as a dopamine and noradrenaline reuptake inhibitor to break the cycle of addiction: dopamine is implicated in craving and noradrenaline in withdrawal symptoms. Clinical trials involving 1500 patients (1) showed bupropion to be twice as effective as nicotine replacement therapy. The results also showed that 30% of subjects were not smoking after one year compared to 16% using nicotine replacement therapy patches.

It is recommended that bupropion be used alone since combining with nicotine replacement therapy may raise blood pressure. This possibility needs further investigation. Side effects to date have been mild and transient with the most common reports being insomnia, dry mouth and headache. No dependency has so far been demonstrated. A support programme is also provided by the manufacturer (2).

References

1. New England Journal of Medicine, 340: 685 (1999).

2. Pharmaceutical Journal, 265: 9 (2000).