Research and Clinical Trials on Bupropion (Amfebutamone, Wellbutrin, Zyban)

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By Dr Greg Mulhauser

This list of current clinical research trials on Bupropion (Amfebutamone, Wellbutrin, Zyban) is followed by a short set of abstracts from the most recent research articles published on the drug.

Article Contents

Bupropion (Amfebutamone, Wellbutrin, Zyban) Clinical Research Trials

From our searchable database at ClinicalTrialsFeeds.org, this list includes all the latest information about clinical trials involving Bupropion (Amfebutamone, Wellbutrin, Zyban).

 

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Current Research Literature on Bupropion (Amfebutamone, Wellbutrin, Zyban)

Here are abstracts for some of the latest research articles to have appeared on Bupropion (Amfebutamone, Wellbutrin, Zyban):

Therapeutic strategies to optimize the efficacy of nicotine replacement therapies.

COPD. 2009 Aug; 6(4): 272-6
Berlin I
Smoking is estimated to be responsible for at least 2/3 of chronic obstructive pulmonary disease (COPD) deaths. Mortality rates due to all causes and to COPD decline progressively after smoking cessation compared with continuing smoking. Nicotine replacement therapies (NRT) increase the likelihood of smoking abstinence by only 60%. Optimization of NRT is of importance in COPD patients because they may be more nicotine dependent and have more difficulties to quit than smokers without COPD. The objective was to critically review pharmacotherapeutic strategies to optimize the efficacy of NRT. Findings revealed that fixed high dose NRT does not convincingly result in higher abstinence rate compared with standard dose and increases the likelihood of adverse effects in smokers with low need for nicotine. Combination of NRT of different routes of administration versus single NRT provides a statistically significant benefit over a single NRT. A 2-week treatment by nicotine patch before quit day approximately doubles post-quit day abstinence. NRT augmentation with burpropion or nortriptyline, antidepressants with demonstrated efficacy for smoking cessation, does not seem to ameliorate further abstinence rates. Three months' and 6 months' NRT exposure was compared by only one but sufficiently powered study and found similar abstinence rates. Optimization strategies to increase the efficacy of NRT include combining NRT of different routes of administration and use of nicotine patch before target quit day. Uncertainties exist about the optimal length of NRT administration. Co-administration of NRT with bupropion or nortriptyline does not seem to lead to higher abstinence rate than NRT alone.

Crossing Borders: Factors Affecting Differences in Cost-Effectiveness of Smoking Cessation Interventions between European Countries.

Value Health. 2009 Sep 25;
Vemer P, Rutten-van Mölken MP
ABSTRACT Objectives: Many different factors affect the transferability of cost-effectiveness results between countries. The objective is to quantify the impact of nine potential causes of variation in cost-effectiveness of pharmacological smoking cessation therapies (SCTs) between The Netherlands (reference case), Germany, Sweden, UK, Belgium, and France. Methods: The life-time benefits of smoking cessation were calculated using the Benefits of Smoking Cessation on Outcomes model, following a cohort of smokers making an unaided quit attempt, or using nicotine replacement therapy (NRT), bupropion, or varenicline. We investigated the impact of between-country differences in nine factors-demography, smoking prevalence, mortality, epidemiology and costs of smoking-related diseases, resource use and unit costs of SCTs, utility weights and discount rates-on the incremental net monetary benefit (INMB), using a willingness-to-pay (WTP) of euro 20,000 per quality adjusted life year (QALY). Results: The INMB of 1000 quit attempts with NRT versus unaided, varies from euro 0.39 million (Germany) to euro 1.47 million (France). The differences between the countries were primarily due to differences in discount rates, causing the INMB to change between -65% to +62%, incidence and mortality rates (epidemiology) of smoking-related diseases (-43% to +35%) and utility weights. Impact also depended on the WTP for a QALY and time horizon: at a low WTP or a short time horizon, the resource use and unit costs of SCTs had the highest impact on INMB. Conclusions: Although all INMBs were positive, there were significant differences across countries. These were primarily related to choice of discount rate and epidemiology of diseases.

Clozapine-induced sialorrhea alleviated by bupropion - A case report.

Prog Neuropsychopharmacol Biol Psychiatry. 2009 Sep 30;
Stern RG, Bellucci D, Cursi-Vogel N, Hughley J, Elangovan N
Sialorrhea is a common and often debilitating side effect in clozapine treated patients. We report here the case of a schizophrenia patient with severe clozapine induced sialorrhea. The sequential addition of benztropine, trihexyphenidyl, scopolamine patch, sublingual ipatropium bromide, oxybutynin, and tolterodine failed to improve the sialorrhea. However the addition of bupropion to the patient's medication regimen resulted in marked improvement in sialorrhea. To our knowledge this is the first report of bupropion treatment for clozapine induced sialorrhea. Our findings warrant further exploration.

Varenicline and suicidal behaviour: a cohort study based on data from the General Practice Research Database.

BMJ. 2009; 339: b3805
Gunnell D, Irvine D, Wise L, Davies C, Martin RM
OBJECTIVE: To determine whether varenicline, a recently licensed smoking cessation product, is associated with an increased risk of suicide and suicidal behaviour compared with alternative treatments bupropion and nicotine replacement therapy. DESIGN: Cohort study nested within the General Practice Research Database. SETTING: Primary care in the United Kingdom. PARTICIPANTS: 80,660 men and women aged 18-95 years were prescribed a new course of a smoking cessation product between 1 September 2006 and 31 May 2008; the initial drugs prescribed during follow-up were nicotine replacement products (n=63 265), varenicline (n=10 973), and bupropion (n=6422). MAIN OUTCOME MEASURES: Primary outcomes were fatal and non-fatal self harm, secondary outcomes were suicidal thoughts and depression, all investigated with Cox's proportional hazards models. RESULTS: There was no clear evidence that varenicline was associated with an increased risk of fatal (n=2) or non-fatal (n=166) self harm, although a twofold increased risk cannot be ruled out on the basis of the upper limit of the 95% confidence interval. Compared with nicotine replacement products, the hazard ratio for self harm among people prescribed varenicline was 1.12 (95% CI 0.67 to 1.88), and it was 1.17 (0.59 to 2.32) for people prescribed bupropion. There was no evidence that varenicline was associated with an increased risk of depression (n=2244) (hazard ratio 0.88 (0.77 to1.00)) or suicidal thoughts (n=37) (1.43 (0.53 to 3.85)). CONCLUSION: Although a twofold increased risk of self harm with varenicline cannot be ruled out, these findings provide some reassurance concerning its association with suicidal behaviour.

Pharmacotherapy treatment of PTSD and comorbid disorders.

Psychiatr Danub. 2009 Sep; 21(3): 411-4
Kozarić-Kovacić D
Comorbity is very high in posttraumatic stress disorder (PTSD) patients. PTSD is very often complicated with depressive disorder, substance abuse, other anxiety disorders, personality disorders, psychotic features, etc. There have been few pharmacotherapy studies in this complicated field. In the past few years the literature on pharmacotherapy treatment for PTSD and comorbidity has arisen. From empirical evidence (level A) exist three sertraline studies in PTSD comorbid with: 1) anxiety, 2) depression, and 3) anxiety and depression, and one risperidone study in PTSD comorbid with psychotic symptoms. From empirical evidence (level B) exist two disulfiram, naltrexone, and their combination studies in patients with PTSD comorbid with alcohol dependence and one paroxetine or bupropion versus cognitive behavioral therapy (CBT) versus community mental health referral study in PTSD women outpatients with major depressive disorder. The results from our label trials in the Croatian war veterans with chronic PTSD comorbid with psychotic features treated with novel antipsychotics (olanzapine, risperidone, or quetiapine) are promising. In the future more rigorously designed, comparative studies are needed to determine the usefulness, efficacy, tolerability, and safety of particular psychopharmaceutical drugs in the treatment of this therapeutically and functionally challenging disorder, especially the trials from level A.

 

This page was last reviewed by Dr Greg Mulhauser, Monday, 1 June 2009.

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