Our library of drug research abstracts drawn from the medical literature is updated on a regular schedule, and you can be assured that new zyban research articles will be listed here shortly after becoming available to us.
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Medical research on zyban
J Gen Intern Med. 2008 Jun 29;
Thomas JL, Guo H, Lynam IM, Powell JN, Okuyemi KS, Bronars CA, Ahluwalia JS
BACKGROUND: The double-blind placebo-controlled design is commonly considered the gold standard in research methodology; however, subject expectation bias could subvert blinding. OBJECTIVE: The primary aim of this study was to examine the impact of expectation bias. Specifically, we examined perceived treatment assignment on smoking cessation outcome rates among participants enrolled in a clinical trial of bupropion (150 mg SR, BID). DESIGN: Analyses were conducted on data collected during "Kick It at Swope," a double-blind, placebo-controlled, randomized trial of 600 African-American smokers. Chi-square and multiple logistic regression analyses were used to examine the impact of perception of assignment on treatment effect and cotinine-verified smoking abstinence rates. PARTICIPANTS: Participants were predominantly middle-aged (mean 44.7, SD 11.2), African-American women (68.6%), who smoked 19 CPD (SD = 8.1). Most had completed at least a high school education or GED (51.6%), and 55% had a monthly family income
Nicotine Tob Res. 2008 Jun; 10(6): 995-1008
Paterson NE, Balfour DJ, Markou A
Bupropion is an effective anti-smoking agent in humans, but the behavioral mechanisms mediating this effect are unclear. The present studies assessed the effects of chronic bupropion on the reinforcing and reward-enhancing effects of self-administered nicotine, and on the motivational properties of a nicotine-associated conditioned reinforcer. The present studies also assessed the reward-enhancing effects of nicotine self-administration under different levels of access to nicotine, and the effects of enforced abstinence from self-administered nicotine on brain reward function and somatic signs. Rats were prepared with bipolar electrodes in the lateral hypothalamus and trained on a discrete trial intracranial self-stimulation (ICSS) task. After establishing stable ICSS thresholds, rats were prepared with intravenous catheters and allowed to self-administer nicotine at different levels of access. Self-administered nicotine lowered ICSS thresholds, thereby providing a measure of the reward-enhancing effects of nicotine. Abstinence from 6h/d 7d/wk nicotine self-administration was associated with increased somatic signs of nicotine withdrawal and unchanged brain reward thresholds. Chronic bupropion administration via subcutaneous osmotic minipump had no effect on nicotine self-administration, but attenuated nicotine-induced enhancement of brain reward function and enhanced the motivational properties of a previously nicotine-associated conditioned stimulus. Thus, it is unlikely that chronic bupropion exerts anti-smoking effects by attenuating the primary or conditioned reinforcing effects of nicotine. Rather, preclinical investigations suggest that bupropion attenuates nicotine-induced enhancement of brain reward function and reverses the anhedonic, somatic, and neurochemical correlates of nicotine withdrawal.
Survey of treatment practices for sexual dysfunction(s) associated with anti-depressants.
J Sex Marital Ther. 2008; 34(4): 353-65
Balon R, Segraves RT
There are many management strategies and antidotes available for sexual dysfunction associated with antidepressants available. However, only a few of these strategies and antidotes were tested in rigorous trials and most of them probably will not be rigorously tested. Surveying the prescribing practices of experts in this area provides another opportunity to evaluate these strategies and antidotes. The authors surveyed 29 (of 50) "expert" psychiatrists in the area of sexual dysfunction associated with antidepressants. Switching to another antidepressant, decreasing the dose of an antidepressant, and adding oral agents such as bupropion, phosphodiesterase-5 inhibitors, and some dopaminergic agents (dextroamphetamine, methylphenidate) and a testosterone patch in some dysfunctions (libido, orgasm) are management strategies most frequently used by the experts. The experts also consider these strategies as the most effective ones. These findings are compared with other studies and discussed with regard to the evidence from clinical trials.
New Zealand smoking cessation guidelines.
N Z Med J. 2008; 121(1276): 57-70
McRobbie H, Bullen C, Glover M, Whittaker R, Wallace-Bell M, Fraser T
AIMS: To summarise the key recommendations made in the 2007 New Zealand Smoking Cessation Guidelines. METHODS: A comprehensive literature review of smoking cessation interventions was undertaken in November 2006. Recommendations were formulated from the findings of the literature review in line with the methods recommended by the New Zealand Guidelines Group. RESULTS: The Guidelines have been structured around a new memory aid (ABC) which incorporates and replaces the 5A's (ask, advise, assess, assist, arrange). ABC prompts healthcare professionals to ask about smoking status; give brief advice to stop smoking to all smokers; and provide evidence-based Cessation support for those who wish to stop smoking. Healthcare professionals should briefly advise all people who smoke to stop smoking, regardless of whether they say they are ready to stop smoking or not. They should then offer smoking cessation support which includes both behavioural (e.g. telephone and face-to-face support) and pharmacological (e.g. nicotine replacement therapy, nortriptyline, bupropion, or varenicline) interventions. Recommendations were also formulated for priority populations of smokers: Māori, Pacific, pregnant women, and people with mental illness and other addictions. CONCLUSIONS: These guidelines will assist healthcare professionals in providing evidence-based smoking cessation support to people who smoke. To be effective, the ABC model needs to be integrated into routine practice.
Physical activity as a strategy for maintaining tobacco abstinence: A randomized trial.
Prev Med. 2008 May 16;
Prochaska JJ, Hall SM, Humfleet G, Muňoz RF, Reus V, Gorecki J, Hu D
OBJECTIVES: For smoking cessation, physical activity (PA) may help manage withdrawal symptoms, mood, stress, and weight; yet studies of PA as an aid for smoking cessation have been mixed. This study examined: (1) the impact of an extended relapse prevention program on increasing moderate to vigorous PA (MVPA) in adults enrolled in a tobacco cessation treatment trial; (2) whether changes in MVPA were associated with sustained abstinence from smoking; and (3) mechanisms by which MVPA may support sustained abstinence from smoking. METHODS: In a randomized controlled trial conducted from 2003-2006 in San Francisco, California, 407 adult smokers received a 12 week group-based smoking cessation treatment with bupropion and nicotine patch with the quit date set at week 3. At week 12, participants were randomized to no further treatment or to 40 weeks of bupropion or placebo with or without an 11-session relapse prevention intervention of which 2 sessions (held at weeks 16 and 20) focused on PA. Participants receiving the PA intervention (n=163) received a pedometer, counseling to increase steps 10% biweekly towards a 10,000 steps/day goal, and personalized reports graphing progress with individualized goals. The International Physical Activity Questionnaire assessed weekly minutes of MVPA at baseline and weeks 12 and 24. Sustained abstinence from tobacco at week 24 was validated with expired carbon monoxide. RESULTS: In a repeated mixed model analysis, intervention participants significantly increased their MVPA relative to control participants, F(1,475)=3.95, p=.047. Pedometer step counts also increased significantly, t(23)=2.36, p=.027, though only 15% of intervention participants provided 6 weeks of pedometer monitoring. Controlling for treatment condition, increased MVPA predicted sustained smoking abstinence at week 24, odds ratio=1.84 (95% CI: 1.07, 3.05). Among participants with sustained abstinence, increased MVPA was associated with increased vigor (r=0.23, p=.025) and decreased perceived difficulty with staying smoke-free (r=-0.21, p=.038). CONCLUSION: PA promotion as an adjunct to tobacco treatment increases MVPA levels; changes in MVPA predict sustained abstinence, perhaps by improving mood and self-efficacy.
[The importance of treating tobacco dependence]
Rev Esp Cardiol. 2008 Jun; 61(6): 620-8
McRobbie H, Thornley S
Smoking is a well-established risk factor for cardiovascular disease (CVD). Stopping smoking confers significant health benefits and is especially important for those with pre-exisiting CVD. Healthcare facilities should have systems in place to enable the identification of people who smoke, and ensure that smokers receive evidence based treatments to provide the best possible chances of stopping for good. Physicians have a crucial role to play to prompt quit attempts by giving brief advice to stop, and offering cessation support. Behavioural support strategies such as telephone, individual and group-based counselling improve the chances of long-term abstinence. Nicotine replacement therapy, bupropion and varenicline are medicines that have proven efficacy in aiding smoking cessation and increase the odds of quitting about 2-3 fold compared to placebo. Even patients with established cardiovascular disease can safely use nicotine replacement therapy to help them quit. For the greatest chance of success, physicians should recommend a combination of behavioural support and pharmacotherapy.
Neuropsychiatr Dis Treat. 2005 Mar; 1(1): 3-7
Pinder RM
Noradrenaline has long played a key role in the way the etiology of depression is conceptualized and in the mechanism of action of many current antidepressants. Tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), serotonin-noradrenaline reuptake inhibitors (SNRIs), selective noradrenaline reuptake inhibitors (NRIs), the noradrenergic and specific serotonergic antidepressant (NaSSA) mirtazapine, and many atypicals, like mianserin and bupropion, influence, at least in part, central noradrenergic function. Enhancement of noradrenergic function may be particularly helpful in patients with melancholia. However, while noradrenaline will continue to be a target for research into the etiology and treatment of depression, it is unlikely that antidepressants acting solely on noradrenaline will be pursued.
Bupropion SR in adults with ADHD: a short-term, placebo-controlled trial.
Neuropsychiatr Dis Treat. 2005 Sep; 1(3): 245-51
Reimherr FW, Hedges DW, Strong RE, Marchant BK, Williams ED
Increased attention has been given to the alternatives to stimulants in the treatment of attention deficit hyperactivity disorder (ADHD) in both adults and children. This short-term, double-blind trial was designed to evaluate the extended-release form of bupropion in adult subjects meeting DSM-IV and the Utah Diagnostic Criteria for ADHD. Outcome measures were the Clinical Global Impressions-Improvement (CGI-I) and the Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS), which assesses adult ADHD symptoms. Outcome (defined by the CGI-I, average WRAADDS scores, or a 50% improvement on the WRAADDS) favored bupropion SR over placebo, but achieved statistical significance on only one, post hoc measure. Other measures showed trends for improvement with bupropion. Given the small size of this study, these findings deserve further exploration.
Endogenous dopamine suppresses initiation of swimming in pre-feeding zebrafish larvae.
J Neurophysiol. 2008 Jun 18;
Thirumalai V, Cline HT
Dopamine is a key neuromodulator of locomotory circuits, yet, the role that dopamine plays during development of these circuits is less well understood. Here, we describe a suppressive effect of dopamine on swim circuits in larval zebrafish. Zebrafish larvae exhibit marked changes in swimming behavior between 3 days post fertilization (dpf) and 5dpf. We found that swim episodes were fewer and of longer durations at 3dpf than at 5dpf. At 3dpf, application of dopamine as well as bupropion, a dopamine reuptake blocker, abolished spontaneous fictive swim episodes. Blocking D2 receptors increased frequency of occurrence of episodes and activation of adenylyl cyclase, a downstream target inhibited by D2-receptor signaling, blocked the inhibitory effect of dopamine. Dopamine had no effect on motor neuron firing properties, input impedance, resting membrane potential or the amplitude of spike after-hyperpolarization. Application of dopamine either to the isolated spinal cord or locally within the cord does not decrease episode frequency, whereas dopamine application to the brain silences episodes suggesting a supraspinal locus of dopaminergic action. Treating larvae with 10microM 1-methyl 4-phenyl 1,2,3,6-tetrahydropyridine hydrochloride (MPTP) reduced catecholaminergic innervation in the brain and increased episode frequency. These data indicate that dopamine inhibits the initiation of fictive swimming episodes at 3dpf. We found that at 5dpf, exogenously applied dopamine inhibits swim episodes yet the dopamine reuptake blocker or the D2 receptor antagonist have no effect on episode frequency. These results lead us to propose that endogenous dopamine release transiently suppresses swim circuits in developing zebrafish.
J Psychopharmacol. 2008 Jun 18;
Eller T, Vasar V, Shlik J, Maron E
Abstract Studies so far have provided contradictory results on immune system markers during use of antidepressants. There are no data on changes in immune parameters after treatment augmentation. The present study aimed to clarify whether the addition of bupropion in escitalopram-resistant patients with major depression causes changes in the immune system and whether treatment response could be predicted by baseline levels of cytokines. We recruited 28 depressive patients (11 men and 17 women) who did not respond to 12-week treatment with escitalopram (20 mg/d) for an augmentation trial with bupropion (150-300 mg/day). The levels of soluble interleukin-2 receptor, interleukin-8 (IL-8) and tumor-necrosis factor-alpha were measured before and 6 weeks after addition of bupropion. For a control group, we recruited 45 healthy volunteers (19 men and 26 women). The results indicated that the baseline levels of studied cytokines did not predict treatment response to bupropion augmentation. Concentration of IL-8 increased during the treatment similarly in both responder and non-responder groups. Although bupropion augmentation had increased the response rate in escitalopram-resistant patients, this clinical improvement was not accompanied by specific changes in studied cytokine levels.