A 12-Week Double-Blind, Placebo-Controlled Study of Bupropion SR Added to High-Dose Dual Nicotine Replacement Therapy for Smoking Cessation or Reduction in Schizophrenia
Abstract
The objective of this study was to examine whether there is a benefit of adding bupropion SR to high-dose combination nicotine replacement therapy (NRT) and weekly group cognitive behavioral therapy (CBT) for smoking reduction or cessation in schizophrenia. Fifty-one adult smokers with schizophrenia were randomly assigned to a 12-week trial of bupropion SR 300 mg/d or placebo added to transdermal nicotine patch, nicotine polacrilex gum, and CBT. The treatment goal was smoking cessation. The primary outcome measure was biochemically confirmed 7-day point-prevalence of 50% to 100% smoking reduction at week 12. Secondary outcomes were biochemically confirmed tobacco abstinence and change from baseline in expired air carbon monoxide (CO) and psychiatric symptoms. Subjects on bupropion + NRT had a greater rate of 50% to 100% smoking reduction at weeks 12 (60% vs. 31%; P = 0.036) and 24, a lower expired air CO in the treatment and follow-up periods, (F = 13.8; P < 0.001) and a greater continuous abstinence rate at week 8, before NRT taper, (52% vs. 19%; P = 0.014). However, relapse rates in subjects on bupropion + dual NRT were 31% during NRT taper (weeks 8-12) and 77% at the 12-month follow-up. Abstinence rates did not differ by treatment group at weeks 12 (36% vs. 19%), 24 (20% vs. 8%), or 52 (12% vs. 8%). Because abstinence rates were high during treatment with combination pharmacotherapy and relapse rates were very high during taper and after discontinuation of treatment, study of longer term treatment with combination pharmacotherapy and CBT for sustained abstinence is warranted in those who attain initial abstinence with this intervention.
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Three other trials comparing a combination to patch alone have not replicated this result.
“Three other trials comparing a combination to patch alone have not replicated this result (109–111).”
From Tobacco addiction (2008) · cites this paper as [111]
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- Authors
- Evins, A. E., Cather, C., Culhane, M. A., Birnbaum, A., Horowitz, J., Hsieh, E., Freudenreich, O., Henderson, D. C., Schoenfeld, D. A., Rigotti, N. A., & Goff, D. C.
- Affiliations
- Harvard University (US)
- University of Massachusetts Chan Medical School (US)
- Massachusetts General Hospital (US)
- Corresponding author
- Evins, A. Eden
- Cather, Corinne
- Horowitz, Jonathan
- Hsieh, Elaine
- Freudenreich, Oliver
- Henderson, David C.
- Goff, Donald C.
- ORCID
- Venue
- Journal of Clinical Psychopharmacology
- Published
- 2007-08
- Volume
- 27
- Issue
- 4
- Pages
- 380-386
- ISSN
- 0271-0749 (ISSN-L)
- OpenAlex
- W2055399144
- Cited by
- 179
- References
- 49
- Citations by year
- 2025: 3 · 2024: 2 · 2023: 5 · 2022: 3 · 2021: 8 · 2020: 8 · 2019: 12 · 2018: 10 · 2017: 10 · 2016: 12 · 2015: 13 · 2014: 7 · 2013: 5 · 2012: 19
- FWCI
- 10.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Public Health Service (05B1MACMHS-04)
- National Institute on Drug Abuse (K23DA000510)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- bupropion, nicotine replacement therapy, smoking cessation, smoking reduction, schizophrenia, cognitive behavioral therapy, nicotine patch, nicotine gum, relapse, smoking abstinence, expired carbon monoxide, combination pharmacotherapy
- MeSH terms
- Adult, Carbon Monoxide, Delayed-Action Preparations, Double-Blind Method, Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Nicotine, Psychiatric Status Rating Scales, Schizophrenia, Schizophrenic Psychology, Smoking Cessation, Bupropion, Sample Size, Antidepressive Agents, Second-Generation, Nicotinic Agonists
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