Researchers randomly assigned 32 schizophrenic cigarette smokers, who were clinically stable on antipsychotic medications and with a strong desire to quit smoking, to receive bupropion or placebo for 10 weeks. During the study, participants were periodically evaluated for smoking urges, depression, and symptoms of schizophrenia. They also attended weekly smoking cessation group therapy that included motivational enhancement therapy, social skills training, and relapse-prevention strategies.
At the end of the study, 50 percent of the participants who received bupropion reported that they had quit smoking, compared with about 12 percent who received a placebo. Smoking abstinence was objectively verified with breath carbon monoxide levels. Further, more than 37 percent of those who received bupropion and less than 13 percent of those who received a placebo remained abstinent from smoking during the last four weeks of the study. Bupropion significantly reduced the negative symptoms of schizophrenia--poor motivation, lack of emotional expression, and inability to form appropriate social relationships. It had no effect, however, on cravings for tobacco or depression.
Patients treated with the newer atypical antipsychotic medications, rather than traditional antipsychotic medications, had better smoking cessation outcomes with bupropion.
WHAT IT MEANS: The findings of this study indicate that bupropion may be a safe and effective treatment for nicotine addiction in schizophrenic patients.
This study, funded in part by the National Institute on Drug Abuse, is published in the July, 2002 issue of Biological Psychiatry.