stevenshof.nl

OBJECTIVE: To describe the patterns of use of bupropion in daily clinical practice and factors which determine successful smoking cessation. METHODS: Retrospective follow-up study in 36 pharmacies in the Netherlands. Patients who received at least one prescription for bupropion between January and April, 2000 were included. The pharmacists noted several characteristics relating to the patient, use of bupropion and co-medication. Patients were interviewed by telephone about their current and former smoking habits, the success of their smoking cessation and their experiences with bupropion. MAIN OUTCOME MEASURE: Abstinence rate and factors determining successful abstinence after six months. RESULTS: 322 patients with a least one prescription for bupropion were identified. In 93.5% of patients bupropion was prescribed by the general practitioner. Half of the patients were dispensed 30 or fewer tablets. Pharmacists interviewed 215 (66.8%) patients by telephone. Of these patients 58 (27.0%) still did not smoke six months after the prescription for bupropion. The number of tablets used, lack of co-morbidity, less than two previous attempts to stop smoking and private-insurance were associated with a higher rate of successful abstinence. CONCLUSION: Most patients do not use bupropion in accordance with the recommended period and did not receive the same degree of additional support provided in clinical trials. Nevertheless 27.0% of patients reported to have stopped smoking six months after the prescription for bupropion. This self-reported abstinence rate is only slightly lower than is reported in literature. This might be partly related to the fact that we did not validate smoking cessation by carbonmonoxide monitoring. Bupropion




Pneumonol Alergol Pol. 2003;71(3-4):148-53.
[Smoking cessation program based on pharmacological support (bupropion SR). Our own experience]

[Article in Polish]

Porebska I, Golecki M, Kasibowska-Kuzniar K, Werynska B, Jankowska R.

Katedry i Kliniki Chorob Pluc Akademii Medycznej, Wroclawiu.

Smoking constitutes the gravest, yet avoidable, deadly threat to health in Poland. Near the end of the 90-ies it was discovered that the antidepressant -bupropion- has positive effects in the treatment of addiction to nicotine. The aim of the study was the evaluation of the efficacy of ambulatory, intensive smoking cessation program based on bupropion SR with educational support. 54 smokers (18 men and 36 women) were enrolled, age 22-59 yr. (mean 45.5 +/- 8.7), smoking 10-50 cigarettes daily. Early abstinence rate (7 weeks after quitting) was 61.1%, after 6 months 45.2% of the participants were still non-smokers. The most common adverse effects of bupropion SR therapy were mouth dryness and sleep disturbances, 13% of patients had to stop using bupropion because of side effects. High percentage of abstinence indicates that intensive smoking cessation programs should be used as a part of antinicotine strategy. The pharmacological support in the nicotine dependence treatment should be performed under careful physician supervision.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14587420&dopt=Abstract Bupropion Wellbutrin




J Pharm Pharmacol. 2003 Sep;55(9):1229-39.
Effect of bupropion on CYP2B6 and CYP3A4 catalytic activity, immunoreactive protein and mRNA levels in primary human hepatocytes: comparison with rifampicin.

Hesse LM, Sakai Y, Vishnuvardhan D, Li AP, Von Moltke LL, Greenblatt DJ.

Department of Pharmacology and Experimental Therapeutics and the Department of Biochemistry, Tufts University School of Medicine, Boston, MA 02111, USA.

Animals treated with multiple doses of bupropion have had increased bupropion clearance or increased liver weight, suggesting induction of drug-metabolizing activity. The possibility of cytochrome p450 (CYP) induction by bupropion (10 microM) was evaluated in-vitro by comparing catalytic activity, immunoreactive protein and CYP mRNA levels from human hepatocytes in primary culture versus cells treated with vehicle (0.5% methanol) and with rifampicin (rifampin) as a positive control. mRNA levels were analysed using a branched DNA luminescent assay. CYP2B6 activity, protein and mRNA levels were increased by 2.5, 1.5 and 2.1 fold, respectively, by 20 microM rifampicin. However, 10 microM bupropion minimally altered CYP2B6 (1.4, 1.1, 0.8 fold). Although CYP3A4 activity, protein, and mRNA levels were increased by 4.0, 2.3, and 14.0 fold, respectively, by 20 microM rifampicin, 10 microM bupropion minimally altered CYP3A4 (1.4, 1.0, 0.8 fold). Rifampicin (20 microM) increased CYP2E1 protein by 2.1 fold, while 10 microM bupropion minimally altered CYP2E1 protein (1.2 fold). Overall, results of this study suggest that multiple doses of bupropion are not likely to induce CYP2B6, 3A4 or 2E1 in-vivo in man.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14604466&dopt=Abstract Bupropion Wellbutrin

bigfoot.com

The case is reported of a patient who had taken a deliberate overdose of sustained release bupropion. The patient suffered from prolonged symptoms including seizures before fully recovering. The prescription of bupropion is encouraged as an aid to smoking cessation and it is probable that bupropion overdose will become more common. Emergency departments need to be aware that patients taking an overdose of sustained release bupropion may have a delayed onset and prolonged course of symptoms. The pharmacology, clinical features, and treatment of bupropion overdose are discussed.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14623854&dopt=Abstract Bupropion Wellbutrin

sghms.ac.uk

BACKGROUND: Nicotine replacement therapies (NRT) and a new drug, bupropion, are licensed in several countries as aids to smoking cessation. General practitioners (GPs) play a crucial role in recommending or prescribing these medications. In the UK there has been discussion about whether the medications should be reimbursable by the National Health Service (NHS). This study assessed English GPs' attitudes towards reimbursement of NRT and bupropion. METHODS: Postal survey of a randomly selected national sample of GPs; 376 GPs completed the questionnaire after one reminder; effective response rate: 53%. There was no difference between the responses of GPs who responded to the initial request and those who responded only after a reminder suggesting minimal bias due to non-response. RESULTS: Attitudes of GPs were remarkably divided on most issues relating to the medications. Forty-three percent thought that bupropion should not be on NHS prescription while 42% thought that it should be (15% did not know); Fifty percent thought that NRT should not be on NHS prescription while 42% thought it should be (8% did not know). Requiring that smokers attend behavioural support programmes to be eligible to receive the medications on NHS prescription made no appreciable difference to the GPs' views. GPs were similarly divided on whether having the medications reimbursable would add unacceptably to their workload or offer a welcome opportunity to discuss smoking with their patients. A principal components analysis of responses to the individual questions on NRT and bupropion revealed that GPs' attitudes could be understood in terms of a single 'pro-con' dimension accounting for 53% of the total variance which made no distinction between the two medications. CO