Schizophrenics smoke at higher rates (58-88%) than the general population (~22%), and have great difficulty with quitting smoking. We determined if the combination of sustained-release (SR) bupropion (BUP) with transdermal nicotine patch (TNP) is well-tolerated, and superior to placebo (PLO) + TNP for smoking cessation in schizophrenia.
Ten-week, double-blind, placebo-controlled trial of BUP (300 mg/day) in combination with TNP (21 mg/24h) and behavioral smoking cessation therapy for fifty-eight outpatient smokers with schizophrenia. Primary outcome measures were continuous smoking abstinence in the last four weeks of the trial (Days 43-70) and 7-day point prevalence abstinence at six month post-TQD (Week 26).
Smokers assigned to the BUP+TNP group (n=29) were more likely to achieve continuous smoking abstinence (8/29, 27.6%) than the PLO+TNP group (n=29, 1/29, 3.4%) [Fisher’s Exact Test Statistic, p<0.05; NNT=5]; at 6-months post-TQD, 4/29 (13.8%) versus 0/29 (0.0%) achieved 7-day point prevalence smoking abstinence (p=0.11; NNT=8). Neither bupropion SR nor smoking abstinence significantly altered the positive or negative symptoms of schizophrenia or depressive symptoms. The combination was well-tolerated in schizophrenic smokers.
Combination therapy with bupropion SR+TNP versus placebo+TNP is well-tolerated and leads to significant improvement in short-term smoking abstinence outcomes in smokers with schizophrenia.
Keywords: Schizophrenia, Nicotine Dependence, Smoking Cessation, Bupropion, sustained-release, Transdermal Nicotine Patch, Clinical Trial