Bupropion
Antidepressive Agents, Second-Generation
Dopamine Uptake Inhibitors
Smoking Cessation
Nicotine
Delayed-Action Preparations
Nicotinic Agonists
Tobacco Use Disorder
Nomifensine
Aryl Hydrocarbon Hydroxylases
Dipyrone
Herb-Drug Interactions
Methamphetamine
Antidepressive Agents
Hydroxylation
Substance Withdrawal Syndrome
Double-Blind Method
A controlled trial of sustained-release bupropion, a nicotine patch, or both for smoking cessation. (1/379)
BACKGROUND AND METHODS: Use of nicotine-replacement therapies and the antidepressant bupropion helps people stop smoking. We conducted a double-blind, placebo-controlled comparison of sustained-release bupropion (244 subjects), a nicotine patch (244 subjects), bupropion and a nicotine patch (245 subjects), and placebo (160 subjects) for smoking cessation. Smokers with clinical depression were excluded. Treatment consisted of nine weeks of bupropion (150 mg a day for the first three days, and then 150 mg twice daily) or placebo, as well as eight weeks of nicotine-patch therapy (21 mg per day during weeks 2 through 7, 14 mg per day during week 8, and 7 mg per day during week 9) or placebo. The target day for quitting smoking was usually day 8. RESULTS: The abstinence rates at 12 months were 15.6 percent in the placebo group, as compared with 16.4 percent in the nicotine-patch group, 30.3 percent in the bupropion group (P<0.001), and 35.5 percent in the group given bupropion and the nicotine patch (P<0.001). By week 7, subjects in the placebo group had gained an average of 2.1 kg, as compared with a gain of 1.6 kg in the nicotine-patch group, a gain of 1.7 kg in the bupropion group, and a gain of 1.1 kg in the combined-treatment group (P<0.05). Weight gain at seven weeks was significantly less in the combined-treatment group than in the bupropion group and the placebo group (P<0.05 for both comparisons). A total of 311 subjects (34.8 percent) discontinued one or both medications. Seventy-nine subjects stopped treatment because of adverse events: 6 in the placebo group (3.8 percent), 16 in the nicotine-patch group (6.6 percent), 29 in the bupropion group (11.9 percent), and 28 in the combined-treatment group (11.4 percent). The most common adverse events were insomnia and headache. CONCLUSIONS: Treatment with sustained-release bupropion alone or in combination with a nicotine patch resulted in significantly higher long-term rates of smoking cessation than use of either the nicotine patch alone or placebo. Abstinence rates were higher with combination therapy than with bupropion alone, but the difference was not statistically significant. (+info)Pharmacological characterization of nicotine's interaction with cocaine and cocaine analogs. (2/379)
Cocaine and a number of 3beta-phenyltropane cocaine analogs were investigated for their potential to block various pharmacological effects of nicotine in animals. They blocked the antinociceptive effect of nicotine in the tail-flick test after systemic administration in a dose-dependent manner. Similarly, cocaine was also able to block nicotine-induced motor impairment in mice. Furthermore, cocaine blocked nicotine-induced seizures at a lower potency than for antinociception, but failed to block nicotine's effect on body temperature and drug discrimination. The antagonistic potencies of the 3beta-phenyltropane cocaine analogs were not correlated with their affinity for monoamines transporters. Additionally, bupropion, nomifensin, GBR 12909, and nisoxetine, but not methylphenidate and fluoxetine, blocked nicotine-induced antinociception; however, their antagonistic potencies were unrelated to their affinities for the transporters. Taken together, these results suggest that the mechanism of cocaine's antagonistic activity is not related to its binding and uptake of inhibition on monoamine neurotransporters. The failure of lidocaine and procaine to antagonize nicotine's effects in the tail-flick assay rules out local anesthetic effects. In addition, cocaine blocked differentially the response of nicotine in the oocyte receptor expression system for the alpha4beta2 and alpha3beta2 subtypes in a dose-dependent manner. Our results suggest that cocaine is a noncompetitive nicotinic antagonist with some selectivity for neuronal nicotinic receptor subtypes. Our studies also demonstrate that 3beta-phenyltropane analogs constitute a new class of nicotinic antagonists. Elucidation of the mechanism of action of this new class of antagonists may provide an explanation for the effectiveness of agents such as bupropion for the treatment of smoking cessation. (+info)Drug coverage decisions: the role of dollars and values. (3/379)
Given the increasing costs of pharmaceuticals today, it is important to understand how pharmacy benefits decisions are made and the role of cost and values in these decisions. This study examines what coverage decisions insurers make and the information and processes used in making these decisions. Fifty-three organizations, differing in size, tax status, and region, were asked about their policies for four new and controversial drugs: Viagra, Enbrel, Zyban, and Celebrex. Enbrel and Celebrex were much more likely to be covered than Viagra and Zyban. In addition, coverage of Enbrel and Celebrex was limited through strategies such as prior authorization, to encourage medically appropriate use of these agents, whereas coverage of Viagra and Zyban was limited predominantly through generalized exclusion or through restrictions on quantity or duration of use. Value judgments, rather than cost, seem to play a central, though largely unspoken, role in these coverage decisions. (+info)Antidepressants upregulate messenger RNA levels of the neuroprotective enzyme superoxide dismutase (SOD1). (4/379)
OBJECTIVE: To investigate the effect of amitriptyline, bupropion, doxepin or venlafaxine on the gene expression of the neuroprotective enzyme superoxide dismutase (SOD1) in a catecholamine cell in vitro model. DESIGN: Molecular study of a cultured cell line. INTERVENTIONS: Rat pheochromocytoma (PC12) cells were incubated in 1 and 10 mumol/L of various antidepressant medications for 24 or 48 hours. OUTCOME MEASURES: Northern blot analysis. RESULTS: Amitriptyline up-regulated SOD1 messenger RNA in a time- and dose-dependent manner. The greatest up-regulation was following incubation with 10 mumol/L amitriptyline for 48 hours. The addition of bupropion, doxepin or venlafaxine to PC12 cell cultures also up-regulated SOD1 mRNA. CONCLUSIONS: These findings suggest that some antidepressants have the ability to positively regulate neuroprotective genes. (+info)Bupropion is a nicotinic antagonist. (5/379)
Neuronal nicotinic receptors are ligand-gated ion channels of the central and peripheral central nervous system that regulate synaptic activity from both pre- and postsynaptic sites. The present study establishes the acute interaction of bupropion, an antidepressant agent that is also effective in nicotine dependence, with nicotine and nicotinic receptors using different in vivo and in vitro tests. Bupropion was found to block nicotine's antinociception (in two tests), motor effects, hypothermia, and convulsive effects with different potencies in the present investigation, suggesting that bupropion possesses some selectivity for neuronal nicotinic receptors underlying these various nicotinic effects. In addition, bupropion blocks nicotine activation of alpha(3)beta(2), alpha(4)beta(2), and alpha(7) neuronal acetylcholine nicotinic receptors (nAChRs) with some degree of selectivity. It was approximately 50 and 12 times more effective in blocking alpha(3)beta(2) and alpha(4)beta(2) than alpha(7.) This functional blockade was noncompetitive, because it was insurmountable by increasing concentration of ACh in the nAChRs subtypes tested. Furthermore, bupropion at high concentration failed to displace brain [(3)H]nicotine binding sites, a site largely composed of alpha(4)beta(2) subunit combination. Given the observation that bupropion inhibition of alpha(3)beta(2) and alpha(4)beta(2) receptors exhibits voltage-independence properties, bupropion may not be acting as an open channel blocker. These effects may explain in part bupropion's efficacy in nicotine dependence. Our present findings suggest that functional blockade of neuronal nAChRs are useful in nicotine dependence treatment. (+info)CYP2B6 mediates the in vitro hydroxylation of bupropion: potential drug interactions with other antidepressants. (6/379)
The in vitro biotransformation of bupropion to hydroxybupropion was studied in human liver microsomes and microsomes containing heterologously expressed human cytochromes P450 (CYP). The mean (+/-S.E.) K(m) in four human liver microsomes was 89 (+/-14) microM. In microsomes containing cDNA-expressed CYPs, hydroxybupropion formation was mediated only by CYP2B6 at 50 microM bupropion (K(m) 85 microM). A CYP2B6 inhibitory antibody produced more than 95% inhibition of bupropion hydroxylation in four human livers. Bupropion hydroxylation activity at 250 microM was highly correlated with S-mephenytoin N-demethylation activity (yielding nirvanol), another CYP2B6-mediated reaction, in a panel of 32 human livers (r = 0.94). The CYP2B6 content of 12 human livers highly correlated with bupropion hydroxylation activity (r = 0.96). Thus bupropion hydroxylation is mediated almost exclusively by CYP2B6 and can serve as an index reaction reflecting activity of this isoform. IC(50) values for inhibition of a CYP2D6 index reaction (dextromethorphan O-demethylation) by bupropion and hydroxybupropion were 58 and 74 microM, respectively. This suggests a low inhibitory potency versus CYP2D6, the clinical importance of which is not established. Since bupropion is frequently coadministered with other antidepressants, IC(50) values (microM) for inhibition of bupropion hydroxylation were determined as follows: paroxetine (1.6), fluvoxamine (6.1), sertraline (3.2), desmethylsertraline (19.9), fluoxetine (59.5), norfluoxetine (4.2), and nefazodone (25.4). Bupropion hydroxylation was only weakly inhibited by venlafaxine, O-desmethylvenlafaxine, citalopram, and desmethylcitalopram. The inhibition of bupropion hydroxylation in vitro by a number of newer antidepressants suggests the potential for clinical drug interactions. (+info)Validation of bupropion hydroxylation as a selective marker of human cytochrome P450 2B6 catalytic activity. (7/379)
The purpose of this study was to establish bupropion (BUP) hydroxylation as a selective in vitro marker of cytochrome P450 (CYP) 2B6 catalytic activity. Among a panel of 16 human liver microsomes (HLMs), BUP hydroxylase activity varied 80-fold when assayed at 500 microM substrate and significantly correlated with CYP2B6 blotting density (r(2) = 0.99) and S-mephenytoin N-demethylase activity (r(2) = 0.98). Kinetic analysis of BUP hydroxylation was performed in a subset of seven HLMs representative of the 80-fold range in activity. Sigmoidal kinetics suggestive of allosteric activation was observed in five HLMs exhibiting low or high activity; the mean apparent K(m) for BUP hydroxylation in these HLMs (130 microM) was similar to the K(m) for cDNA-expressed CYP2B6 (156 microM). Nonsaturable, biphasic kinetics was observed in two HLMs exhibiting low activity. Among a panel of cDNA-expressed P450 isoforms, CYP2B6 and CYP2E1 demonstrated the highest rates of BUP hydroxylation at 12 mM BUP (7.0 and 2.4 pmol/min/pmol of P450, respectively). The relative contributions of CYP2B6 and CYP2E1 to BUP hydroxylation were estimated by using immunoinhibitory monoclonal antibodies (MAB) to these enzymes. MAB-2B6 produced 88% maximum inhibition of BUP hydroxylation when assayed at 12 mM BUP in a high activity HLM, whereas MAB-2E1 produced 81% maximum inhibition in a low activity HLM. However, negligible inhibition by MAB-2E1 was observed when low and high activity HLMs were assayed at 500 microM BUP. These results demonstrate selectivity of BUP hydroxylation for CYP2B6 at 500 microM BUP, thereby validating its use as a diagnostic in vitro marker of CYP2B6 catalytic activity. (+info)Smoking cessation guidelines for health professionals: an update. Health Education Authority. (8/379)
This paper updates the evidence base and key recommendations of the Health Education Authority (HEA) smoking cessation guidelines for health professionals published in Thorax in 1998. The strategy for updating the evidence base makes use of updated Cochrane reviews supplemented by individual studies where appropriate. This update contains additional detail concerning the effectiveness of interventions as well as comments on issues relating to implementation. The recommendations include clarification of some important issues addressed only in general terms in the original guidelines. The conclusion that smoking cessation interventions delivered through the National Health Service are an extremely cost effective way of preserving life and reducing ill health remains unchanged. The strategy recommended by the guidelines involves: (1) GPs opportunistically advising smokers to stop during routine consultations, giving advice on and/or prescribing effective medications to help them and referring them to specialist cessation services; (2) specialist smokers' services providing behavioural support (in groups or individually) for smokers who want help with stopping and using effective medications wherever possible; (3) specialist cessation counsellors providing behavioural support for hospital patients and pregnant smokers who want help with stopping; (4) all health professionals involved in smoking cessation encouraging and assisting smokers in use of nicotine replacement therapies (NRT) or bupropion where appropriate. The key points of clarification of the previous guidelines include: (1) primary health care teams and hospitals should create and maintain readily accessible records on the current smoking status of patients; (2) GPs should aim to advise smokers to stop, and record having done so, at least once a year; (3) inpatient, outpatient, and pregnant smokers should be advised to stop as early as possible and the advice recorded in the notes in a readily accessible form; (4) there is currently little scientific basis for matching individual smokers to particular forms of NRT; (5) NHS specialist smokers' clinics should be the first point of referral for smokers wanting help beyond what can be provided through brief advice from the GP; (6) help from trained health care professionals specialising in smoking cessation such as practice nurses should be available for smokers who do not have access to specialist clinics; (7) the provision of specialist NHS smokers' clinics should be commensurate with demand; this is currently one or two full time clinics or their equivalent per average sized health authority, but demand may rise as publicity surrounding the services increases. (+info)Tobacco use disorder refers to a condition where an individual engages in the excessive and compulsive consumption of tobacco products, despite the negative consequences it may have on their health and well-being. Tobacco use disorder is a common condition that affects millions of people worldwide, and it is characterized by a pattern of continued tobacco use despite harmful effects, as well as an increased tolerance to tobacco and withdrawal symptoms when trying to stop.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines tobacco use disorder as a chronic condition that can manifest in different forms, including nicotine dependence and tobacco abuse. The criteria for diagnosing tobacco use disorder include:
1. Tolerance: A need to use more tobacco to achieve the desired effect.
2. Withdrawal: Experiencing symptoms such as irritability, anxiety, or depression when trying to stop using tobacco.
3. Loss of control: Consuming more tobacco than intended or for longer periods than intended.
4. Negative consequences: Continuing to use tobacco despite social, physical, or psychological problems caused by its use.
5. Increased time and effort spent on using tobacco.
6. Craving or a strong desire to use tobacco.
7. Failure to control or reduce tobacco use.
Tobacco use disorder can have severe consequences, including lung cancer, heart disease, respiratory problems, and other health issues. It can also lead to social and economic problems, such as lost productivity and strained relationships with family and friends. Treatment for tobacco use disorder includes behavioral therapies, medications, and support groups, and it is important for individuals struggling with this condition to seek professional help to quit using tobacco and improve their overall health and well-being.
The following are some common amphetamine-related disorders:
1. Amphetamine Use Disorder (AUD): This is a chronic condition characterized by the excessive and compulsive use of amphetamines, despite negative consequences. Individuals with AUD may experience withdrawal symptoms when they stop using the drug, and may continue to use to avoid these symptoms or to achieve a "high."
2. Stimulant Psychosis: This is a condition in which an individual experiences hallucinations, delusions, or disorganized thinking due to the use of amphetamines. It is often seen in individuals who have a history of substance abuse and/or mental health issues.
3. Amphetamine-Induced Psychotic Disorder: This condition is similar to stimulant psychosis, but it is specifically caused by the use of amphetamines. It can include hallucinations, delusions, and disorganized thinking.
4. Cognitive Impairment: Long-term use of amphetamines can lead to cognitive impairments, such as memory loss, difficulty with attention, and decreased problem-solving skills.
5. Sleep Disturbances: Amphetamine use can disrupt sleep patterns, leading to insomnia or other sleep disorders.
6. Malnutrition: Individuals who use amphetamines may neglect their nutritional intake, leading to malnutrition and related health problems.
7. Cardiovascular Problems: Amphetamine use can increase heart rate and blood pressure, which can lead to cardiovascular problems such as heart attack, stroke, and arrhythmias.
8. Dental Problems: The dry mouth caused by amphetamine use can lead to tooth decay and other dental problems.
9. Infectious Diseases: Sharing needles or engaging in other risky behaviors to obtain amphetamines can increase the risk of contracting infectious diseases such as HIV/AIDS and hepatitis.
10. Financial and Legal Problems: The high cost of maintaining an amphetamine habit can lead to financial problems, and criminal activity to support the habit can lead to legal problems.
It is important to note that the specific risks associated with amphetamine use can vary depending on the individual, their health status, and the dose and duration of use. If you or someone you know is struggling with amphetamine addiction, it is important to seek professional help as soon as possible.
* Anxiety
* Depression
* Fatigue
* Insomnia
* Muscle and bone pain
* Nausea and vomiting
* Seizures (in severe cases)
* Sweating
* Tremors
The specific symptoms of substance withdrawal syndrome can vary depending on the substance being withdrawn from, but some common symptoms include:
* Alcohol: tremors, anxiety, insomnia, nausea and vomiting, headaches, and seizures
* Opioids: withdrawal symptoms can include anxiety, muscle aches, sweating, nausea and vomiting, diarrhea, and depression
* Benzodiazepines: withdrawal symptoms can include anxiety, insomnia, tremors, and seizures
The diagnosis of substance withdrawal syndrome is typically made based on the patient's history of substance use and the presence of withdrawal symptoms. A healthcare provider may also order laboratory tests to rule out other conditions that may be causing the symptoms. Treatment for substance withdrawal syndrome usually involves supportive care, such as rest, hydration, and pain management, as well as medication to manage withdrawal symptoms. In some cases, medical professionals may also recommend a gradual tapering of the substance over a period of time to minimize withdrawal symptoms.
It is important for individuals who are experiencing withdrawal symptoms to seek medical attention as soon as possible, as untreated withdrawal can lead to serious complications, such as seizures and dehydration. With appropriate treatment, most individuals with substance withdrawal syndrome can recover fully and successfully overcome their addiction.
Bupropion
List of side effects of bupropion
Zonisamide
List of dopaminergic drugs
Mecamylamine
Antidepressant
Attention deficit hyperactivity disorder management
Hypoactive sexual desire disorder
CYP2D6
Drug rehabilitation
Generic drug
Threohydrobupropion
Schizoaffective disorder
Nariman Mehta
Sanofi
Radafaxine
Social anxiety disorder
Serotonin syndrome
Butaxamine
Depression in childhood and adolescence
Erythrohydrobupropion
Elbert Glover
Anti-obesity medication
Effects of cannabis
Selective serotonin reuptake inhibitor
Tinnitus
Anticholinergic
Fitness to dive
Amfepramone
Major depressive disorder
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- I encourage them to talk to their doctors, get counseling, call quitlines (1-800-QUIT-NOW), get information online or on their phones (text the word QUIT to 47848), and use FDA-approved cessation medications like bupropion SR (Zyban ® ), varenicline tartrate (Chantix ® ) or nicotine replacement products (patch, gum, lozenge, inhaler, or nasal spray). (cdc.gov)
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- METHODS Adult outpatients who had chronic and/or recurrent major depressive disorder (MDD) with and without general medical conditions were randomly assigned in 1:1:1 ratio to 28 weeks of single-blind, placebo-controlled antidepressant treatment with (1) escitalopram plus placebo, (2) bupropion-SR plus escitalopram, or (3) venlafaxine-XR plus mirtazapine. (annfammed.org)
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- Initially researched and marketed as an antidepressant, bupropion was subsequently found to be effective as a smoking cessation aid. (drugsupdate.com)
- Bupropion is an effective antidepressant on its own but it is particularly popular as an add-on medication in the cases of incomplete response to the first-line SSRI antidepressant. (drugsupdate.com)
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Adult2
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- This study aimed to identify factors associated with adverse cardiovascular events in adult patients with isolated bupropion exposures. (bvsalud.org)
Treatment7
- Your health care provider will want to see you often while you are taking bupropion, especially at the beginning of your treatment. (medlineplus.gov)
- We hypothesized that 6 weeks of bupropion sustained release (SR) treatment would decrease craving for Internet game play as well as video game cue-induced brain activity in patients with Internet video game addiction (IAG). (nih.gov)
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Brain2
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Adverse2
- Clinical and electrocardiographic factors associated with adverse cardiovascular events in bupropion exposures. (bvsalud.org)
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Drug1
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Side effects1
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Works1
- Bupropion works differently than SSRIs or SNRIs. (medlineplus.gov)