Effect of stress and bupropion on craving, withdrawal symptoms, and mood in smokers.

Abstract

INTRODUCTION:

Studies suggest that in smokers attempting to quit smoking, the occurrence of stressful events is associated with smoking relapse. The purpose of this study was to determine the effect of bupropion (an agent known to increase smoking cessation rates) on the craving, withdrawal, and mood response to stressful tasks administered in a laboratory setting.

METHODS:

Response to three tasks (a speech, math, and cold pressor task) was measured in 65 smokers during ad libitum smoking. Smokers were then randomized to either bupropion or placebo. Fourteen days after starting medication, 43 subjects (28 receiving bupropion and 15 receiving placebo) quit smoking and laboratory procedures were repeated on the third day of abstinence.

RESULTS:

Prior to cessation, stressors presented in a laboratory setting increased craving, nicotine withdrawal symptoms, and subjective distress but decreased positive affect. Thirty minutes of relaxation after the stressors did not result in these measures returning to prestress levels. During the nicotine withdrawal period, stress-induced responses were generally smaller than during the precessation period. Bupropion (relative to placebo) reduced overall levels of craving and withdrawal symptoms but did not have significant effects on response to stress during the nicotine withdrawal period.

CONCLUSIONS:

This study demonstrates that stress results in sustained increases in craving and withdrawal symptoms and changes in mood symptoms and that bupropion affects overall levels of these symptoms. Further research is needed to determine if modifying response to stress is predictive of an effective treatment for facilitating smoking cessation.

• Authors: Michael Kotlyar, David Drone, Paul Thuras, Dorothy K Hatsukami, Lisa Brauer, David E Adson, Mustafa al'Absi
• Journal: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco (Nicotine Tob Res) Vol. 13 Issue 6 Pg. 492-7 (Jun 2011) ISSN: 1469-994X [Electronic] England
• PMID: 21378081 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Antidepressive Agents, Second-Generation
• Bupropion

Topics

• Adolescent
• Adult
• Affect (drug effects)
• Aged
• Antidepressive Agents, Second-Generation (administration & dosage, pharmacology, therapeutic use)
• Bupropion (administration & dosage, pharmacology, therapeutic use)
• Counseling
• Female
• Humans
• Male
• Middle Aged
• Smoking Cessation (methods)
• Stress, Psychological (complications, psychology)
• Substance Withdrawal Syndrome (drug therapy, prevention & control, psychology)
• Tobacco Use Disorder (drug therapy, prevention & control)
• Treatment Outcome
• Young Adult