Abstract
BACKGROUND: This study evaluated the efficacy of bupropion for relapse prevention in smokers with and without a past history of major depressive disorder. Changes in depressive symptoms were also examined.
DESIGN: Data were gathered prospectively from a randomized, double-blind relapse prevention trial of bupropion conducted at five study sites. A total of 784 smokers (54% female, 97% white) were enrolled. Using the Structured Clinical Interview for Depression, 17% of the subjects reported a past history of major depressive disorder at baseline. All subjects received open-label bupropion SR (300 mg/d) for 7 weeks. Subjects abstinent from smoking at the end of 7 weeks (N=429) were randomized to bupropion SR (300 mg/d) or placebo for the remainder of the year and followed for 1 year off medication. The primary outcome measures were median time to relapse to smoking and the 7-day point-prevalence smoking abstinence rate. Self-reported abstinence from smoking was verified by expired air carbon monoxide. The Beck Depression Inventory was used to assess depressive symptoms at baseline and at weeks 8 and 12.
RESULTS: Median time to relapse did not differ by past history of major depressive disorder. Bupropion was associated with higher point-prevalence smoking abstinence at the end of medication compared to placebo (P=.007), independent of a past history of major depressive disorder. Moreover, change in depressive symptoms during the double-blind phase did not differ for those with and without a past history of major depressive disorder.
CONCLUSIONS: Extended use of bupropion for relapse prevention is effective for smokers with and without a history of major depression.
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This study was supported by a grant from Glaxo Wellcome, Inc. Findings of this study were presented in part at the Society for Research on Nicotine and Tobacco, 7th annual meeting, Seattle, Wash, March 2001.
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Cox, L.S., Patten, C.A., Niaura, R.S. et al. Efficacy of bupropion for relapse prevention in smokers with and without a past history of major depression. J GEN INTERN MED 19, 828–834 (2004). https://doi.org/10.1111/j.1525-1497.2004.30423.x
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DOI: https://doi.org/10.1111/j.1525-1497.2004.30423.x