Zyban helps keep smokers from relapse
ROCHESTER, Minn., Sept 17 (UPI) -- Mayo Clinic researchers say a drug
designed to help people quit smoking also may help keep them from having a
relapse, but the effect wears off once they stop taking it.
Dr. James Taylor-Hayes gave Zyban or a placebo to 429 smokers who already
had achieved smoking cessation using Zyban, known as bupropion. He told
United Press International that 55 percent of smokers who continued taking
300 milligrams of Zyban for 45 weeks did not return to smoking compared to
42.3 percent of those who took the placebo. But a year after the medicine
was stopped, there was no difference in the relapse rate between the two
Hayes reported the findings in Tuesday' s issue of Annals of Internal
The longest lasting benefit of Zyban was its effect on weight gain
associated with smoking cessation. Hayes said patients in the placebo group
gained more weight and that weight difference was still evident a year after
medication was stopped.
This finding coincides with other studies of bupropion as a weight loss
aide. Hayes said on average smokers gain about 10 pounds after quitting, but
weight gain often is higher among women. He added weight gain seen in former
smokers usually is "caused because former smokers just eat more," which
makes bupropion a good option for avoiding post-smoking flab.
The drug affects the pleasure center of the brain by increasing release of
a brain chemical called dopamine. Nicotine use also increases the release of
dopamine and it is this action that causes the pleasure that smokers
associate with cigarettes. Eating also triggers dopamine release and when
dopamine levels are high enough, one has the sensation of being full or
"Bupropion use appears to be linked to earlier satiation," Hayes said.
Addiction specialist Dr. Tony Tommasello of the University of Maryland
School of Pharmacy in Baltimore said while the study demonstrates Zyban can
be effective in both smoking cessation and relapse prevention, it also
suggests "you can't rewire the brain with a pill."
Smoking changes several aspects of brain chemistry, he said. So while
increasing dopamine can solve some of the "wiring" problems, long-term
success in smoking cessation requires making physical changes that can
"re-train the brain," he told UPI.
For example, he said a smoker who starts his or her car and then pushes in
the cigarette lighter may have to remove the cigarette lighter from the car
to re-train both brain and body after years of nicotine addiction.
Bupropion was first approved for use as an anti-depressant, which is sold
under the name Wellbutrin in both immediate release and sustained release
preparations. Under the name Zyban, the drug is only available in
long-acting preparations. Both Zyban and Wellbutrin are made by Glaxo
Wellcome Inc., which funded the study.