[Antidepressive drug against nicotine. A method for smoking cessation]

Currently, two drugs are considered useful for those wishing to quit smoking in Germany--nicotine and bupropion. The mechanism of action appears to involve reuptake inhibition of the transmitters noradrenaline and/or dopamine by the brain. Treatment with a daily dose of 300 mg delayed release buproplon for 7 to 9 weeks resulted in smoking cessation in 30.3% (buproplon) and 35.5% (bupropion plus nicotine patch) of the smokers at 12 months (placebo: 15.6%, nicotine patch: 16.4%). A large number of the participants had had negative experience with nicotine preparations in previous attempts to stop smoking. Most side effects of bupropion involve the nervous system (disturbed sleep, trembling, loss of concentration, headache, dizziness, depression, restlessness, anxiety) and the gastrointestinal tract (dry mouth, nausea, vomiting, abdominal pain, constipation) and elevated temperature (> 1% of the treated subjects). It is suggested that, at present, bupropion should be used for this indication only in those smokers in whom treatment with nicotine has failed.