Bupropion sustained release as a smoking cessation treatment in remitted depressed patients maintained on treatment with selective serotonin reuptake inhibitor antidepressants
Bupropion sustained release as a smoking cessation treatment in remitted depressed patients maintained on treatment with selective serotonin reuptake inhibitor antidepressants
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DOI：
10.4088/jcp.v62n07a01
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发表时间：
2001-07-01
影响因子：
5.3
通讯作者：
Levine, J
中科院分区：
文献类型：
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作者：
Chengappa, KNR;Kambhampati, RK;Levine, J
背景：抑郁症患者比一般人群更常吸烟，戒烟更困难。此外，当他们戒烟时，他们更有可能复发抑郁症。我们评估了添加安非他酮缓释剂（SR）用于有抑郁症病史的患者戒烟，这些患者使用选择性5-羟色胺再摄取抑制剂（SSRI）抗抑郁药维持在正常状态。方法：25名患有DSM的成年人IV型重度抑郁症或抑郁症NOS目前接受SSRI维持治疗，每天吸烟≥ 15支，参与9-周学习。将安非他酮SR（150 mg/天）添加到SSRI治疗中，并增加至300 mg/天。受试者接受戒烟措施的咨询，并在开始安非他酮SR治疗后2或4周选择目标戒烟日期。每次访视时测量自我报告的吸烟状况、呼出的一氧化碳（CO）测量值、汉密尔顿抑郁和焦虑评分量表和体重。受试者是禁欲的，如果他们报告不吸烟在前7天，确认与空气中的CO值小于或等于10 ppm.Results：8（32%）的25名受试者9周后禁欲。在3个月随访时，3例受试者保持禁欲，3例复发，2例失访。11例受试者（44%）为无应答者，6例（24%）在治疗3周前因副作用（N = 3）退出或失访（N = 3）。对于完成9周安非他酮SR治疗的患者，平均体重增加约为0.5磅（0.2公斤）。在9周研究和3个月随访期间，任何受试者均未出现抑郁症状。四名受试者（16%）自发地报告了SSRI-associated sexual dysfunction.Conclusion的改善：这些开放的数据表明适度的有效性和安全性安非他酮SR作为一种戒烟剂在个人抑郁症维持治疗与SSRIs。最小的体重增加，缺乏紧急抑郁发作，并改善SSRI相关的性功能障碍是额外的优势。
Background: Patients with depressive disorders smoke tobacco more often than the population at large and find quitting more difficult. Furthermore, when they quit smoking, they are more likely to suffer a relapse of depression. We evaluated the addition of bupropion sustained release (SR) for smoking cessation among patients with a history of depressive disorders being maintained in a euthymic state with selective serotonin reuptake inhibitor (SSRI) antidepressants.Method: Twenty-five adults with DSM-IV major depressive disorder or depressive disorder NOS currently receiving SSRI maintenance treatment and smoking greater than or equal to 15 cigarettes per day participated in the 9-week study. Bupropion SR, 150 mg/day, was added to SSRI treatment and increased to 300 mg/day. Subjects were counseled on smoking cessation measures and chose a target quit date 2 or 4 weeks after the initiation of bupropion SR. Self-reported smoking status, expired carbon monoxide (CO) measurements, Hamilton Rating Scales for Depression and Anxiety scores, and weight were measured at each visit. Subjects were abstinent if they reported not smoking during the prior 7 days, confirmed with an expired-air CO value of less than or equal to 10 ppm.Results: Eight (32%) of 25 subjects were abstinent after 9 weeks. At 3-month follow-up, 3 subjects remained abstinent, 3 relapsed, and 2 were lost to follow-up. Eleven subjects (44%) were nonresponders, and 6 (24%) dropped out prior to 3 weeks of treatment due to side effects (N = 3) or were lost to follow-up (N = 3). Mean weight gain was approximately 0.5 lb (0.2 kg) for those completing 9 weeks of bupropion SR treatment. During the 9-week study and the 3-month follow-up, there was no evidence of emergent depression in any subject. Four subjects (16%) spontaneously reported an improvement in SSRI-associated sexual dysfunction.Conclusion: These open data suggest modest effectiveness for and the safety of bupropion SR as a smoking cessation agent in individuals with depression maintained on treatment with SSRIs. Minimal weight gain, lack of emergent depressive episodes, and improvement of SSRI-associated sexual dysfunction are added advantages.