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Cited by 1,352Smoking Behavior and CessationSubstance Abuse Treatment and OutcomesNicotinic Acetylcholine Receptors Study

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Antidepressants for smoking cessation

Open access
Howes, Seth, Hartmann-Boyce, Jamie, Livingstone-Banks, Jonathan, Hong, Bosun, Lindson, Nicola·2020·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd000031.pub5PMC PMC7175455
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Abstract

BACKGROUND: Whilst the pharmacological profiles and mechanisms of antidepressants are varied, there are common reasons why they might help people to stop smoking tobacco. Firstly, nicotine withdrawal may produce depressive symptoms and antidepressants may relieve these. Additionally, some antidepressants may have a specific effect on neural pathways or receptors that underlie nicotine addiction. OBJECTIVES: To assess the evidence for the efficacy, safety and tolerability of medications with antidepressant properties in assisting long-term tobacco smoking cessation in people who smoke cigarettes. SEARCH METHODS: We searched the Cochrane Tobacco Addiction Specialized Register, which includes reports of trials indexed in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and PsycINFO, clinicaltrials.gov, the ICTRP, and other reviews and meeting abstracts, in May 2019. SELECTION CRITERIA: We included randomized controlled trials (RCTs) that recruited smokers, and compared antidepressant medications with placebo or no treatment, an alternative pharmacotherapy, or the same medication used in a different way. We excluded trials with less than six months follow-up from efficacy analyses. We included trials with any follow-up length in safety analyses. DATA COLLECTION AND ANALYSIS: We extracted data and assessed risk of bias using standard Cochrane methods. We also used GRADE to assess the certainty of the evidence. The primary outcome measure was smoking cessation after at least six months follow-up, expressed as a risk ratio (RR) and 95% confidence intervals (CIs). We used the most rigorous definition of abstinence available in each trial, and biochemically validated rates if available. Where appropriate, we performed meta-analysis using a fixed-effect model. Similarly, we presented incidence of safety and tolerance outcomes, including adverse events (AEs), serious adverse events (SAEs), psychiatric AEs, seizures, overdoses, suicide attempts, death by suicide, all-cause mortality, and trial dropout due to drug, as RRs (95% CIs). MAIN RESULTS: = 0%; 3 studies, 417 participants). There was no evidence that any of the other antidepressants tested (including St John's Wort, selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs)) had a beneficial effect on smoking cessation. Findings were sparse and inconsistent as to whether antidepressants, primarily bupropion and nortriptyline, had a particular benefit for people with current or previous depression. AUTHORS' CONCLUSIONS: There is high-certainty evidence that bupropion can aid long-term smoking cessation. However, bupropion also increases the number of adverse events, including psychiatric AEs, and there is high-certainty evidence that people taking bupropion are more likely to discontinue treatment compared with placebo. However, there is no clear evidence to suggest whether people taking bupropion experience more or fewer SAEs than those taking placebo (moderate certainty). Nortriptyline also appears to have a beneficial effect on smoking quit rates relative to placebo. Evidence suggests that bupropion may be as successful as NRT and nortriptyline in helping people to quit smoking, but that it is less effective than varenicline. There is insufficient evidence to determine whether the other antidepressants tested, such as SSRIs, aid smoking cessation, and when looking at safety and tolerance outcomes, in most cases, paucity of data made it difficult to draw conclusions. Due to the high-certainty evidence, further studies investigating the efficacy of bupropion versus placebo are unlikely to change our interpretation of the effect, providing no clear justification for pursuing bupropion for smoking cessation over front-line smoking cessation aids already available. However, it is important that where studies of antidepressants for smoking cessation are carried out they measure and report safety and tolerability clearly.

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  1. Wilcox, 2015, A double-blind, active-and placebo-controlled evaluation of the neuropsychiatric safety and efficacy of varenicline and bupropion for smoking cessation in subjects with (pre-existing) psychiatric disorders: an objective blinded analysis, Neuropsychopharmacology, 40, S106
  2. David, 2013, Influence of a dopamine pathway additive genetic efficacy score on smoking cessation: results from two randomized clinical trials of bupropion, Addiction, 108, 2202, 10.1111/add.12325 · DOI
  3. David, 2007, Bupropion efficacy for smoking cessation is influenced by the DRD2 Taq1A polymorphism: Analysis of pooled data from two clinical trials, Nicotine & Tobacco Research, 9, 1251, 10.1080/14622200701705027 · DOI
  4. Uhl, 2008, Molecular genetics of successful smoking cessation: convergent genome-wide association study results, Archives of General Psychiatry, 65, 683, 10.1001/archpsyc.65.6.683 · DOI
  5. Zhu, 2014, Association of CHRNA5-A3-B4 SNP rs2036527 with smoking cessation therapy response in African-American smokers, Clinical Pharmacology and Therapeutics, 96, 256, 10.1038/clpt.2014.88 · DOI
  6. da Costa, 2001, Smoking cessation: A randomized double-blind study comparing nortriptyline to placebo [abstract], American Journal of Respiratory and Critical Care Medicine, 163, A354
  7. Eisenberg, 2011, Bupropion for smoking cessation in patients hospitalized with acute myocardial infarction: A randomized, placebo-controlled trial, Canadian Journal of Cardiology, 27, S344
  8. Filion, 2012, The effect of bupropion on symptoms of depression among patients attempting to quit smoking post-myocardial infarction: the zesca trial, Circulation, 125 Suppl 10, P090
  9. Grandi, 2012, The effect of treatment adherence on smoking abstinence in patients post-acute myocardial infarction, Journal of Population Therapeutics and Clinical Pharmacology, 19, 123
  10. Evins, 2004, Smoking cessation in schizophrenia: A double blind placebo controlled trial of bupropion SR added to cognitive behavioral therapy, Biological Psychiatry, 55, 806
  11. Ferry, 1992, Enhancement of smoking cessation using the antidepressant bupropion hydrochloride, Circulation, 86, I
  12. Ferry, 1994, Efficacy of bupropion for smoking cessation in non depressed smokers [Abstract], Journal of Addictive Diseases, 13, 249
  13. Hall, 2007, Belief about drug assignment and abstinence in treatment of cigarette smoking using nortriptyline, Nicotine & Tobacco Research, 9, 467, 10.1080/14622200701239480 · DOI
  14. Mooney, 2008, Therapeutic drug monitoring of nortriptyline in smoking cessation: a multistudy analysis, Clinical Pharmacology & Therapeutics, 83, 436, 10.1038/sj.clpt.6100307 · DOI
  15. Mooney, 2008, Therapeutic drug monitoring of nortriptyline in smoking cessation: a multistudy analysis, Clinical Pharmacology & Therapeutics, 83, 436, 10.1038/sj.clpt.6100307 · DOI
  16. Hurt, 1996, Bupropion for smoking cessation: A double-blind, placebo-controlled dose response trial, Journal of Addictive Diseases, 15, 137
  17. Hays, 2012, Changes in health-related quality of life with smoking cessation treatment, European Journal of Public Health, 22, 224, 10.1093/eurpub/ckq137 · DOI
  18. Hays JT Leischow SJ Lawrence D Lee TC Adherence to treatment for tobacco dependence: association with smoking abstinence and predictors of adherence Nicotine & Tobacco Research 2010 12 6 574 81 · DOI
  19. King, 2012, Smoking cessation pharmacogenetics: analysis of varenicline and bupropion in placebo-controlled clinical trials, Neuropsychopharmacology, 37, 641, 10.1038/npp.2011.232 · DOI
  20. West, 2008, Effect of varenicline and bupropion SR on craving, nicotine withdrawal symptoms, and rewarding effects of smoking during a quit attempt, Psychopharmacology, 197, 371, 10.1007/s00213-007-1041-3 · DOI · Paper page
  21. McGeary, 2011, Predictors of relapse in a bupropion trial for smoking cessation in recently-abstinent alcoholics: Preliminary results using an aggregate genetic risk score, Behavior Genetics, 41, 923
  22. Okun ML Levine MD Houck P Perkins KA Marcus MD Subjective sleep disturbance during a smoking cessation program: associations with relapse Addictive Behaviors 2011 36 8 861 4 · DOI
  23. McCarthy, 2007, Mechanisms of tobacco cessation treatment: Self-report mediators of counseling and bupropion sustained release treatment, Dissertation Abstracts International: Section B: The Sciences and Engineering, 67, 5414
  24. Mizes, 1996, Fluoxetine and weight-gain in smoking cessation - examination of actual weight-gain and fear of weight-gain [abstract], Psychopharmacology Bulletin, 32, 491
  25. Swan, 1999, Subgroups of smokers with different success rates after treatment with fluoxetine for smoking cessation [abstract], Nicotine & Tobacco Research, 1, 281
  26. Piper, 2007, Bupropion alone and in combination with nicotine gum: Efficacy, mediation and moderation, Dissertation Abstracts International: Section B: The Sciences and Engineering, 67, 5418
  27. Berg, 2012, Alcohol use after tobacco cessation: immediate consequences, Journal of General Internal Medicine, 27, 99
  28. Rigotti, 2005, Safety and efficacy of bupropion for smokers hospitalized with acute cardiovascular disease [abstract], Nicotine & Tobacco Research, 7, 682
  29. Selby, 2003, Sustained-release bupropion (Zybanr) is effective in the re-treatment of relapsed adult smokers, American Journal of Respiratory and Critical Care Medicine, 167, A47
  30. Simon, 2004, Bupropion plus nicotine replacement no better than replacement alone, Journal of Family Practice, 53, 953
  31. Loh, 2012, Should all smokers use combination smoking cessation pharmacotherapy? Using novel analytic methods to detect differential treatment effects over 8 weeks of pharmacotherapy, Nicotine & Tobacco Research, 14, 131, 10.1093/ntr/ntr147 · DOI
  32. Piper, 2010, Gender, race, and education differences in abstinence rates among participants in two randomized smoking cessation trials, Nicotine & Tobacco Research, 12, 647, 10.1093/ntr/ntq067 · DOI
  33. Swan, 2008, Predictors of 12-month outcome in smokers who received bupropion sustained-release for smoking cessation, Central Nervous System Drugs, 22, 239
  34. Patel MK Tashkin DP Kanner RE Bailey WC Buist A Anderson PJ A multicenter evaluation of the effects of bupropion hydrochloride sustained release tablets (Bup SR) versus placebo in a population of smokers with chronic obstructive pulmonary disease (PO130) 11th World Conference on Tobacco or Health; 2000 Aug 6-11; Chicago (IL) 2000 118
  35. Bollinger, 2001, Bupropion hydrochloride (Zyban) is effective and well tolerated as an aid to smoking cessation - a multicountry study. Abstract and presentation at 11th Annual meeting of European Respiratory Society, Berlin, September 22-26 2001, European Respiratory Journal, 18, 12s
  36. Tonstad S Aaserud E Hjalmarson A Peiffer G van der Molen T Hider A Zyban is an effective and well tolerated aid to smoking cessation in a general smoking population - a multi-country study Society for Research on Nicotine and Tobacco 3rd Europe Conference; 2001 September 19-22; Paris, France 2001 46
  37. Spiegel, 2001, Bupropion hydrochloride (Zyban) is an effective and well tolerated aid to smoking cessation in smokers with cardiovascular disease - a multicountry study. Abstract and presentation at 11th Annual meeting of European Respiratory Society, Berlin, September 22-26, European Respiratory Journal, 18, 13s
  38. Uyar, 2005, Comparison of nicotine patch and bupropion in treating tobacco dependence, European Respiratory Journal, 26, 388s
  39. Wagena, 2005, Efficacy of bupropion and nortriptyline for smoking cessation among people who are at risk for or have chronic obstructive pulmonary disease: Results from a randomized, placebo-controlled trial, Nicotine & Tobacco Research, 7, 683
  40. Puska P Brath H Astbury C Hider AE Zyban is an effective and well tolerated aid to smoking cessation in a healthcare professionals population - a multi-country study Society for Research on Nicotine and Tobacco 3rd European Conference; 2001 September 19-22; Paris, France 2001 45
  41. Zellweger, 2001, Bupropion hydrochloride sustained release is an effective and well tolerated aid to smoking cessation in a healthcare professionals population - a multicountry study. Abstract and presentation at 11th Annual meeting of European Respiratory Society, Berlin, September 22-26 2001, European Respiratory Journal, 18, 166s
  42. Zincir, 2012, Comparison of the effects of varenicline, bupropion and nicotine replacement therapy on smoking cessation program, Bulletin of Clinical Psychopharmacology, 22 Suppl 1, S35
  43. Brauer LH Paxton DA Stock CT Rose JE Selegiline and transdermal nicotine for smoking cessation Society for Research on Nicotine and Tobacco Annual Conference; 2000 Feb 18-20; Arlington (VA) 2000
  44. Croghan, 2005, Comparing nicotine inhaler, bupropion and nicotine inhaler plus bupropion in treating tobacco dependence [abstract], Nicotine & Tobacco Research, 7, 680
  45. Evins, 2005, A double blind placebo controlled trial of bupropion added to nicotine patch and cognitive behavioral therapy in smokers with current or past unipolar depressive disorder, Neuropsychopharmacology, 30 Suppl 1, S91
  46. Frederick, 1997, The effect of venlafaxine on smoking cessation in subjects with and without a history of depression, NIDA Research Monograph, 174, 208
  47. Grandi S Shimony A Eisenberg MJ The efficacy and safety of bupropion started in-hospital for smoking cessation in patients with cardiovascular disease: A systematic review and meta-analysis Circulation 2011 124 21 Suppl 1
  48. Hitsman B Spring B Borrelli B Niaura R Papandonatos G Adherence to medication versus behavioral therapy as predictors of smoking cessation in combined treatment involving fluoxetine [abstract] Society for Research on Nicotine and Tobacco Annual Conference; 2000 Feb 18-20; Arlington (VA) 2000
  49. Li J Zhang T Wang B Li X An efficacy analysis of bupropion for smoking cessation in schizophrenia Zhongguo Xinyao Yu Linchuang Zazhi [Chinese Journal of New Drugs and Clinical Remedies] 2009 28 3 231 4
  50. Gratziou, 2002, Evaluation of prolonged bupropion treatment as an aid in smoking cessation [abstract], European Respiratory Journal, 20 Suppl 38, 611s
  51. Rovina, 2003, Short or prolonged treatment with bupropion HCL in smoking cessation therapy, European Respiratory Journal, 22 Suppl 45, 165s
  52. Sittipunt, 2007, The effectiveness of nortriptyline plus brief motivation counseling for the treatment of smoking cessation in Thai active smokers [Abstract], Respirology, 12, A223
  53. Sonntag, 2003, Smoking cessation in primary care: implementation effectiveness and optimized allocation, Suchtmedizin in Forschung und Praxis, 5, 137
  54. Centers for Disease Control and Prevention, 2017, Quitting Smoking Among Adults-United States, 2000-2015, Morbidity and Mortality Weekly Report, 52, 1457
  55. Fiore, 2008, Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. AHRQ publication No. 00-0032
  56. Lerman, 2002, Mediating mechanisms for the impact of bupropion in smoking cessation treatment, Drug and Alcohol Dependence, 67, 219, 10.1016/S0376-8716(02)00067-4 · DOI · Paper page
  57. West, 2008, Effect of varenicline and bupropion SR on craving, nicotine withdrawal symptoms, and rewarding effects of smoking during a quit attempt, Psychopharmacology, 197, 371, 10.1007/s00213-007-1041-3 · DOI · Paper page
  58. West, 2018, Factors associated with the efficacy of smoking cessation treatments and predictors of smoking abstinence in EAGLES, Addiction, 113, 1507, 10.1111/add.14208 · DOI
  59. Hughes, 1994, Non-nicotine pharmacotherapies for smoking cessation, Journal of Drug Development, 6, 197
  60. Hughes, 2002, Antidepressants for smoking cessation, Cochrane Database of Systematic Reviews

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Metadata

Authors
Howes, S., Hartmann-Boyce, J., Livingstone-Banks, J., Hong, B., & Lindson, N.
Affiliations
  • University of Oxford (GB)
  • Nuffield Department of Primary Care Health Sciences; University of Oxford; Oxford UK
  • Birmingham Dental Hospital (GB)
ORCID
Lindson, Nicola
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2020-04-22
Volume
2021
Issue
5
Pages
CD000031-CD000031
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
DOI
10.1002/14651858.cd000031.pub5
PMC
PMC7175455
OpenAlex
W1549559727
Cited by
1,352
References
372
Citations by year
2026: 2 · 2025: 11 · 2024: 26 · 2023: 55 · 2022: 49 · 2021: 45 · 2020: 81
FWCI
7.32
Type
journal article
Language
en
Update notices
new_version (2023-05-24)
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Nicotinic Acetylcholine Receptors Study
Keywords
antidepressants, smoking cessation, nicotine withdrawal, nicotine dependence, bupropion, nortriptyline, selective serotonin reuptake inhibitors, monoamine oxidase inhibitors, Hypericum perforatum, depression, adverse events, drug safety and tolerability, long-term abstinence, nicotine replacement therapy, smoking cessation pharmacotherapy, nicotine withdrawal symptoms
MeSH terms
Varenicline, Antidepressive Agents, Humans, Nortriptyline, Smoking, Anti-Anxiety Agents, Randomized Controlled Trials as Topic, Smoking Cessation, Bupropion, Selective Serotonin Reuptake Inhibitors, Tobacco Use Cessation Devices

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