From the Guidelines
Yes, Wellbutrin (bupropion) is effective for smoking cessation, with a relative risk of 1.62 for smoking abstinence at 6 months or more compared to placebo, as found in a 2014 systematic review 1. The typical dosage for smoking cessation is 150 mg once daily for 3 days, then 150 mg twice daily for 7-12 weeks. You should begin taking it 1-2 weeks before your quit date to build up adequate levels in your system. Wellbutrin works differently from nicotine replacement therapies by affecting dopamine and norepinephrine in the brain, which helps reduce nicotine cravings and withdrawal symptoms. Some key points to consider:
- It approximately doubles your chances of quitting successfully compared to placebo.
- Common side effects include dry mouth, insomnia, and headache.
- Wellbutrin should not be used by people with seizure disorders, eating disorders, or those taking certain medications like MAOIs.
- It can be used alongside nicotine replacement therapies for better results in some cases, but this combination should be discussed with your healthcare provider. A 2016 European guideline also supports the use of bupropion for smoking cessation, stating that it aids long-term smoking cessation with a similar efficacy to NRT 2. Additionally, a 2015 study found that bupropion SR was associated with a significantly higher rate of smoking abstinence at 6 months or more than placebo or no bupropion SR 3. However, it's essential to weigh the benefits and risks, considering the potential for serious adverse effects, such as seizures, and allergic reactions, as noted in a 2000 guideline 4.
From the FDA Drug Label
Bupropion hydrochloride extended-release tablets (XL) are not approved for smoking cessation treatment; however, bupropion HCl sustained-release is approved for this use.
Bupropion can work for smoking cessation, but the specific formulation mentioned, bupropion hydrochloride extended-release tablets (XL), is not approved for this use. However, bupropion HCl sustained-release is approved for smoking cessation 5.
From the Research
Efficacy of Wellbutrin for Smoking Cessation
- Wellbutrin, also known as bupropion, is an effective medication for smoking cessation, as shown in several studies 6, 7, 8, 9, 10.
- Bupropion has been found to increase smoking cessation rates compared to placebo or no pharmacological treatment, with a relative risk of 1.60 (95% CI 1.49 to 1.72) 8.
- The medication is also effective in preventing relapse to smoking in those who have successfully quit, and re-treatment is effective in smokers who recommence smoking after a previous course of bupropion 6.
Comparison with Other Treatments
- Bupropion has been compared to other smoking cessation treatments, including nicotine replacement therapy (NRT) and varenicline, with varying results 7, 8, 9.
- One study found that varenicline was more effective than bupropion for smoking cessation, with a higher cessation rate at both 3 and 12 months 9.
- Another study found that bupropion was as effective as single-form NRT, but less effective than combination NRT and varenicline 8.
Safety and Tolerability
- Bupropion has been found to be generally well-tolerated, with common adverse events including insomnia and dry mouth 6, 10.
- The medication may increase the risk of serious adverse events, including seizures, although the risk is considered low 8, 10.
- Bupropion has also been found to result in more trial dropouts due to adverse events compared to placebo or no pharmacological treatment 8.