The effect of bupropion on nicotine craving and withdrawal

Shiffman, Saul; Johnston, J. Andrew; Khayrallah, M.; Elash, Celeste A.; Gwaltney, Chad J.; Paty, Jean A.; Gnys, Maryann; Evoniuk, Gary; DeVeaugh-Geiss, Joseph

doi:10.1007/s002130050022

Cited by 244 publications

(216 citation statements)

References 24 publications

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“…The findings accord with growing evidence that antidepressants may be used to reduce affective distress following quitting smoking (Hall et al 1998;Shiffman et al 2000;Lerman et al 2002). Notably, fluoxetine produced a reduction in negative affect and a rise in positive affect.…”

Section: Discussionsupporting

confidence: 84%

“…Effects of antidepressants on positive affect are less understood (Zald and Depue 2001). Although Shiffman et al (2000) found that bupropion attenuated a decrease in positive affect in euthymic smokers during 72-h nicotine deprivation, Lerman and colleagues (2002) did not detect an effect of bupriopion on post-cessation positive moods.…”

Section: Introductionmentioning

confidence: 96%

“…Studies on the effects of the agents have, for the most part, focused on the alleviation of negative mood or depressive symptoms. Specifically, euthymic smokers treated with nortryptiline (catecholaminergic and serotonergic actions) or bupropion (dopaminergic and noradrenergic actions), report lower levels of post-cessation negative affect than smokers who did not receive these treatments (Hall et al 1998;Shiffman et al 2000;Lerman et al 2002). Effects of antidepressants on positive affect are less understood (Zald and Depue 2001).…”

Section: Introductionmentioning

confidence: 99%

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Influence of fluoxetine on positive and negative affect in a clinic-based smoking cessation trial

et al. 2004

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Rationale-Fluoxetine improves affect in clinical syndromes such as depression and premenstrual dysphoric disorder. Little is known about fluoxetine's influence on mood changes after quitting smoking, which often resemble sub-clinical depression.Objectives-The present study, a re-analysis of previously published data , examined fluoxetine's effect on changes in negative and positive affect following quitting smoking.Methods-Adult smokers (n=175) without clinically significant depression were randomized on a double-blind basis to receive fluoxetine hydrochloride (30 or 60 mg daily) or placebo for 10 weeks in combination with cognitive-behavioral therapy (CBT) for smoking cessation. We postulated that fluoxetine would beneficially influence post-cessation changes in positive and negative affect.Results-Mood change across treatment was analyzed using mixed linear modeling controlling for initial level of nicotine dependence, plasma fluoxetine metabolites, and change in cotinine (a nicotine metabolite) at each visit. Relative to placebo, those on 60 mg fluoxetine experienced an elevation in positive affect that increased across time [t(526) Conclusions-Results indicate that 60 mg of fluoxetine improves both positive and negative mood states after quitting smoking and that diminished positive affect may be an overlooked affective response to smoking cessation.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

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Influence of fluoxetine on positive and negative affect in a clinic-based smoking cessation trial

et al. 2004

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“…Since pharmacologically treating withdrawal improves treatment outcome for nicotine dependence (see Shiffman et al, 2000) and opiate dependence (Dole, 1988), we have conducted a series of laboratory studies testing the effects of medications on symptoms of marijuana withdrawal. Maintenance on two medications, the antidepressant, bupropion (Haney et al, 2001), and the mood stabilizer, divalproex (Haney et al, 2004), significantly worsened mood during marijuana withdrawal compared to placebo, suggesting that they would not show promise as treatment approaches.…”

Section: Nih-pa Author Manuscriptmentioning

confidence: 99%

“…In the laboratory, marijuana withdrawal is alleviated by the resumption of marijuana smoking or by THC administration, demonstrating the pharmacological specificity of withdrawal (Haney et al, 1999b(Haney et al, , 2004Hart et al, 2002). Clinically, marijuana smokers report using marijuana to alleviate withdrawal symptoms (Budney et al, 1999), suggesting withdrawal contributes to relapse and the maintenance of marijuana use.Since pharmacologically treating withdrawal improves treatment outcome for nicotine dependence (see Shiffman et al, 2000) and opiate dependence (Dole, 1988), we have conducted a series of laboratory studies testing the effects of medications on symptoms of marijuana withdrawal. Maintenance on two medications, the antidepressant, bupropion (Haney et al, 2001), and the mood stabilizer, divalproex (Haney et al, 2004), significantly worsened mood during marijuana withdrawal compared to placebo, suggesting that they would not show promise as treatment approaches.…”

mentioning

confidence: 99%

Effects of THC and lofexidine in a human laboratory model of marijuana withdrawal and relapse

et al. 2007

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Individuals seeking treatment for their marijuana use rarely achieve sustained abstinence.Objectives-To determine if THC, a cannabinoid agonist, and lofexidine, an α 2 -adrenergic receptor agonist, given alone and in combination, decreased symptoms of marijuana withdrawal and relapse, defined as a return to marijuana use after a period of abstinence.Methods-Nontreatment-seeking, male volunteers (n=8), averaging 12 marijuana cigarettes/day, were maintained on each of four medication conditions for 7 days: placebo, THC (60 mg/day), lofexidine (2.4 mg/day), and THC (60 mg/day) combined with lofexidine (2.4 mg/day); each inpatient phase was separated by an outpatient washout phase. During the first 3 inpatient days, placebo marijuana was available for self-administration (withdrawal). For the next 4 days, active marijuana was available for self-administration (relapse). Participants paid for self-administered marijuana using study earnings. Self-administration, mood, task performance, food intake and sleep were measured.Results-THC reversed the anorexia and weight loss associated with marijuana withdrawal, and decreased a subset of withdrawal symptoms, but increased sleep onset latency, and did not decrease marijuana relapse. Lofexidine was sedating, worsened abstinence-related anorexia, and did not robustly attenuate withdrawal, but improved sleep and decreased marijuana relapse. The combination of lofexidine and THC produced the most robust improvements in sleep, and decreased marijuana withdrawal, craving and relapse in daily marijuana smokers relative to either medication alone.Conclusions-These data suggest the combination of lofexidine and THC warrant further testing as a potential treatment for marijuana dependence. KeywordsMarinol; Britlofex; dependence; withdrawal; treatment; cannabinoid; norepinephrine Marijuana use is prevalent in American society, and the number of individuals who currently meet DSM-IV criteria for cannabis abuse or dependence has steadily increased since the 1990s (Compton et al., 2004). Although marijuana is less likely to produce dependence than drugs such as nicotine, alcohol or heroin (Anthony et al., 1994), the sheer number of marijuana smokers combined with the increasing potency of marijuana has NIH Public AccessAuthor Manuscript Psychopharmacology (Berl). Author manuscript; available in PMC 2012 June 12.Published in final edited form as:Psychopharmacology (Berl). 2008 March ; 197(1): 157-168. doi:10.1007/s00213-007-1020-8. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript resulted in a significant number of individuals developing cannabis use disorders, i.e., approximately 1.5% of the U.S. population (Compton et al., 2004).A number of studies have demonstrated that there is a personal (i.e., not court-mandated) demand for marijuana treatment, particularly when marijuana-specific treatment programs are offered (Roffman et al., 1988;Stephens et al., 1993;Lang et al., 2000). Treatmentseekers report distress about their marijuana use, and repeatedly ...

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Effect of Bupropion Treatment on Brain Activation Induced by Cigarette-Related Cues in Smokers

Culbertson

Bramen²,

Cohen³

et al. 2011

Arch Gen Psychiatry

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Context Nicotine-dependent smokers exhibit craving and brain activation in the prefrontal and limbic regions when presented with cigarette-related cues. Bupropion hydrochloride treatment reduces cue-induced craving in cigarette smokers; however, the mechanism by which bupropion exerts this effect has not yet been described. Objective To assess changes in regional brain activation in response to cigarette-related cues from before to after treatment with bupropion (vs placebo). Design Randomized, double-blind, before-after controlled trial. Setting Academic brain imaging center. Participants Thirty nicotine-dependent smokers (paid volunteers). Interventions Participants were randomly assigned to receive 8 weeks of treatment with either bupropion or a matching placebo pill (double-blind). Main Outcome Measures Subjective cigarette craving ratings and regional brain activations (blood oxygen level-dependent response) in response to viewing cue videos. Results Bupropion-treated participants reported less craving and exhibited reduced activation in the left ventral striatum, right medial orbitofrontal cortex, and bilateral anterior cingulate cortex from before to after treatment when actively resisting craving compared with placebo-treated participants. When resisting craving, reduction in self-reported craving correlated with reduced regional brain activation in the bilateral medial orbitofrontal and left anterior cingulate cortices in all participants. Conclusions Treatment with bupropion is associated with improved ability to resist cue-induced craving and a reduction in cue-induced activation of limbic and prefrontal brain regions, while a reduction in craving, regardless of treatment type, is associated with reduced activation in prefrontal brain regions.

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The effect of bupropion on nicotine craving and withdrawal

Abstract: Study results indicate that bupropion ameliorates some nicotine withdrawal symptoms.

Cited by 244 publications

References 24 publications

Influence of fluoxetine on positive and negative affect in a clinic-based smoking cessation trial

Influence of fluoxetine on positive and negative affect in a clinic-based smoking cessation trial

Effects of THC and lofexidine in a human laboratory model of marijuana withdrawal and relapse

Effect of Bupropion Treatment on Brain Activation Induced by Cigarette-Related Cues in Smokers

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