What is it? It’s not a nicotine replacement like Nicorette, the patch or the inhaler; so, how does it function in a smoking cessation effort? What does it do? Is it psychoactive?
It’s an anti-depressant which was found to decrease nicotine cravings. It is sold under the name Zyban for smoking cessation, but it is all the same thing.
It acts in the brain increasing the available brain hormones norepinephrine and dopamine, which are part of the systems governing energy, positive mood, and the sense of satisfaction. (Nah, I don’t feel like I need a smoke right now.)
I hope. Cause that’s what I’ve been teaching med students for years!
Asst Clinical Prof (Psychiatry) oldbat, m.d.
As my wife (who used it … though not long enough … ) said, it eliminates the desire to raise the cigarette to your mouth. She would often find herself lighting a cigarette and letting it burn out without taking many drags.
It combats the other half of smoking–not the nicotine addiction (which she doesn’t have much trouble with … she’s a light smoker and has never had any of the “nic fits” that many of her friends have), but the conditioned behavior pattern. If they made a nicotine-free cigarette, she would smoke it. She’s more addicted to the ritual, the chance for a break, and the comfort that it gives her than she is to the chemicals.
From Medscape
Note that Zyban is a low dose of Wellbutrin and therefore, by drug company logic, costs more.
If you are prescribed Zyban, have the doc change it to Wellbutrin instead.
The technicality, I believe, is that Wellbutrin is approved for depression but not for smoking cessation. Zyban is specifically approved for smoking cessation.
So if your doctor writes you a prescription to stop smoking, you pretty much are supposed to get Zyban (which is newer and has no generic equivalents yet = more $). Wellbutrin doesn’t fit the bill (even though they’re virtually identical). So you would have to have your doctor prescribe you Wellbutrin for depression, instead.
Ah, technicalities.
Zyban is not more expensive than an equivalent strength of Wellbutrin SR. Note the “SR”. That means slow release which is equivalent to the Zyban formulation. Wellbutrin SR is not available generically.
You may be able to use the generic (non SR) version of Wellbutrin for smoking cessation, but be sure to ask your doctor.
I thought nicotiene stimulated the release the of dopamine, hence welbutrin mostly helped the physical end of the addiction. The sense of satisfaction one would derive from the drug might help them brush off the ritual easier, but that’s largely because they’ve just smoked a cigarette without smoking a cigarette. Not entirely unlike nicotiene patches or gum, but substituting the nicotiene with another, less addictive drug that does something similar. To give an oversimplified but fairly clear analogy, welbutrin is to nicotiene as methadone is to heroin.
I took wellbutrin for depression and I was smoking like it was my JOB! Not one little teensy degree of less desire. And it gave me cotton mouth. I hate that.
While it’s true that Welbutrin is not FDA approved for smoking cessation, buproprion (the generic) is and so it doesn’t matter which the MD prescribes. In fact, there is nothing that says you have to prescribe medications only for FDA approved diagnoses. One could theoretically prescribe Welbutrin for high blood pressure, but that would be poor doctoring and could get you sued.
As an example, Prozac (fluoxetine) has recently gone generic, so the drug company is no longer giving samples to clinics. However, the same drug in the same dose has been approved for Pre-Menstrual Dysphoric Disorder and marketed under the name Serafem. I’ve seen MD’s give out Serafem to people as though it were Prozac to treat depression.
Doctors that I’ve worked with have told me that the anti-smoking effects of Welbutrin only work if you want to quit anyway, but are having trouble with the cravings.
USCDiver, who just completed his Psychiatry rotation (did I pass oldbatoutahell?)
I used Zyban to quit smoking and it worked great–for that part of it. I just didn’t feel like smoking at all… However, I had some frightful side-effects and had to discontinue the treatment after two-three weeks. (Still managed to quit in during that time.)
USCD–right you are–I remember wherein the confusion lies, now: It’s an insurance issue. Our insurance co. would pay for a depression treatment, but not a smoking cessation treatment. Rather irrelevant to the whole hijack, I’m afraid. Oh, well.
Get ready for the next ten years’ boom in marketing drugs for their ‘beneficial’ side effects.
Pharmaceutical companies will squeeze every drop of money out of a drug before it goes generic.
My ex-shrink told me that it was because it elevated the levels of dopamine in the brain, much like nicotine will do. I’ve heard other places that it can be used to treat some minor OCD symptoms, such as compulsively wanting to raise your hand to your mouth and take a drag.
I’ve known a couple people who have tried it and some of them said it was great, and some of them said it was crap. One of the ones who said it was great was just getting the placebo effect, I believe (shame - sugar pills would have been much cheaper), as she said it made cigarettes ‘taste really bad’, which didn’t make a great deal of sense to me.
I used Wellbutrin to stop smoking and it work wonders for me.
I aways found that when I wanted to stop smoking in the past, I would do OK for the first two days. Then I would start to think to myself, “Man, a smoke would be great right now”
That would be all I thought about… having a smoke. With the Wellbutrin, I didn’t think of smoking (much.) I didn’t have that nagging, constant craving.
I still had trouble with the “time triggers” i.e. after eating food, when I wake up, driving in a car etc., but after a few weeks those went away.
I haven’t had a smoke for 3 1/2 years.
I did take the Wellbutrin, not the Zyban. My insurance didn’t cover the Zyban, so my Dr. wrote me a prescription for Wellbutrin. He also gave me a months supply of Wellbutrin samples, which helped the wallet
Thanks, all. plain_jane, what sort of side effects did you experience?
My wife had nasty, amphetamine-style side effects when she first tried it: unable to concentrate, manic, elevated heart rate, etc. She said she could basically feel herself going insane. It was also while she was working 18-hour days on a film shoot. She stopped taking it until her life was slightly calmer, and things went just fine.
She also learned that (for her at least), if she didn’t take the pills EXACTLY on schedule, she had side effects. In other words, it wasn’t “take one when you get up, one when you go to bed, etc.”, it was “take one at 8 AM; take the next one at 4 PM; take the next one at 12 Midnight” or there was hell to pay.
“You may be able to use the generic (non SR) version of Wellbutrin for smoking cessation, but be sure to ask your doctor.”
You can’t get generic Wellbutrin.
When Wellbutrin was intitially introduced it did not come in a time released formulation and the result of this was that many people experienced seizures as a side effect.
Once the Wellbutrin was reformulated into a time released formula (SR) the incidence of seizures fell to levels comparable to other anti-depressant medication which are fairly low.
Oldbat has described the physiological effects of this medication on the the brain very accurately.