Smoking Cessation Meds: Take Two

Smoking cessation medications varenicline and bupropion SR go though another trial

(RxWiki News) Quitting smoking can be tough, but it simply has to be done. Researchers keep looking at ways to help people quit for good, even if there are side effects involved.

A small clinical trial tested two smoking cessation medications that are already on the market.

The results showed that both medications helped people quit smoking and reduced nicotine withdrawal symptoms with few side effects.

One of the medications, varenicline (Chantix), has been shown to cause serious side effects in other studies.

"Quit smoking today."

Paul M. Cinciripini, PhD, professor in the Department of Behavioral Science and Director of the Tobacco Treatment Program at the University of Texas MD Anderson Cancer Center in Houston, led a clinical trial on the use of two different smoking cessation medications.

“More than 50 percent of the 45.3 million Americans who still smoke make a serious cessation attempt each year, but only 6 percent of them remain abstinent for at least 6 months,” the authors wrote.

Varenicline (Chantix) and bupropion (Wellbutrin) are prescription medications already on the market to help people manage nicotine withdrawal symptoms when they attempt to quit smoking.

Bupropion may also be prescribed as an antidepressant. Varenicline was specifically designed to work on nicotine receptors in the brain and is only approved for smoking cessation purposes. Serious mental health and cardiovascular side effects have been associated with the use of varenicline.

For this study, 294 smokers in Houston, who all wanted to quit, were split into three medication groups. Each participant was given a daily dose of varenicline, bupropion SR (sustained release) or a placebo (fake pill) for 12 weeks.

All participants were given six face-to-face and four telephone counseling sessions to help with tobacco cessation.

Every week the researchers evaluated the participants for depression, negative affect and any other symptoms of nicotine withdrawal. Symptoms of negative affect, much like a bad mood, can include anger, agitation, depression, anxiety and trouble concentrating.

Nicotine withdrawal symptoms can include hunger, cigarette cravings, headaches and irritability.

At the end of the trial, 48 percent of the varenicline group, 39 percent of the bupropion SR group and 19 percent of the placebo group had successfully quit.

Three months after the trial, 43 percent of the varenicline group, 37 percent of the bupropion SR group and 17 percent of the placebo group were no longer smokers.

Six months after the trial, 28 percent of the varenicline group, 23 percent of the bupropion SR group and 14 percent of the placebo group had still not gone back to smoking.

Overall, 86 percent of the trial participants finished the trial. And of the 23 percent who stopped taking the medication before the end of the trial, 38 percent still stuck with the counseling sessions.

The researchers found that varenicline showed better results than the placebo at helping people to quit smoking.

“Varenicline also had little effect on anxiety and anger, had a suppressive effect on symptoms of depression, and (like bupropion SR) reduced withdrawal-related sadness and negative affect,” concluded the authors.

The authors also noted that these findings contradict other current studies on varenicline. They said this contradiction could be due to the small size of the group. Only 86 people were assigned to take varenicline.

This study was published in March in JAMA Psychiatry.

The study was funded by Pfizer, the makers of Chantix. The National Institutes on Drug Abuse, the National Cancer Institute and a grant from the Cancer Center Support also provided funding for this trial. Dr. Cinciripini reported a financial relationship with the pharmaceutical company Pfizer.

Review Date: 
April 4, 2013