From the Guidelines
For smoking cessation, Wellbutrin (bupropion) is typically prescribed at 150 mg once daily for the first 3 days, then increased to 150 mg twice daily for the remainder of the treatment course, as recommended by the NCCN clinical practice guidelines in oncology 1. The total treatment duration is usually 7-12 weeks. You should begin taking Wellbutrin 1-2 weeks before your quit date to allow the medication to reach effective levels in your body. The medication works by affecting brain chemicals (dopamine and norepinephrine) that are linked to nicotine addiction, helping to reduce cravings and withdrawal symptoms. Some key points to consider when using Wellbutrin for smoking cessation include:
- Common side effects include dry mouth, insomnia, headache, and nausea
- Wellbutrin should not be used if you have a seizure disorder, an eating disorder, or if you're taking certain medications like MAO inhibitors
- For best results, combine Wellbutrin with behavioral support such as counseling
- The medication is available as Wellbutrin SR (sustained-release) or as the generic bupropion, and requires a prescription from your healthcare provider According to a systematic review on the use of antidepressants for smoking cessation, bupropion SR was associated with a significantly higher rate of smoking abstinence at 6 months or more than placebo or no bupropion SR 1. Additionally, a review of behavioral and pharmacotherapy interventions for tobacco smoking cessation found that combinations of behavioral counseling and pharmacotherapy, such as NRT and bupropion SR, were effective in increasing cessation rates 1.
From the Research
Wellbutrin Dose for Smoking Cessation
- The usual recommended dose of bupropion (Wellbutrin) for smoking cessation is 150 mg twice a day, taken for 7-14 days prior to the quit date, and then 6-8 weeks afterwards 2.
- Bupropion has been shown to improve success at staying off cigarettes for at least 12 months by 9-10 percentage points 2.
- Combination therapy with bupropion and varenicline may be more effective for smoking cessation than bupropion monotherapy, with studies showing greater efficacy in achieving smoking abstinence 3, 4.
Side Effects and Contraindications
- Common side effects of bupropion include dry mouth and sleep disturbance, while rare but serious side effects include anaphylactic/hypersensitivity reaction and seizure 2.
- Bupropion is contraindicated in patients with hypersensitivity to the drug or its metabolites, any seizure disorder, eating disorder, severe hepatic cirrhosis, history of bipolar disorder, or in patients taking monoamine oxidase inhibitors 2.
Comparison with Other Treatments
- Varenicline has been shown to be at least as effective as bupropion for smoking cessation, and may be more effective in maintaining abstinence and reducing craving 5, 6.
- Combination therapy with varenicline and bupropion may be more beneficial in males and patients with higher baseline nicotine dependence 3.