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Combination Treatment With Varenicline and Bupropion in an Adaptive Smoking Cessation Paradigm

Publication ,  Journal Article
Rose, JE; Behm, FM
Published in: American Journal of Psychiatry
June 17, 2014

OBJECTIVE The authors assessed the efficacy and safety of combination treatment with varenicline and sustained-release bupropion for smokers who, based on an assessment of initial smoking reduction prior to the quit date, were deemed unlikely to achieve abstinence using nicotine patch treatment. METHOD In a randomized, double-blind, parallel-group adaptive treatment trial, the authors identified 222 cigarette smokers who failed to show a reduction of more than 50% in smoking after 1 week of nicotine patch treatment. Smokers were randomly assigned to receive 12 weeks of varenicline plus bupropion or varenicline plus placebo. The primary outcome measure was continuous smoking abstinence at weeks 8-11 after the target quit date. RESULTS Both treatments were well tolerated. Participants who received the combination treatment had a significantly higher abstinence rate than those who received varenicline plus placebo (39.8% compared with 25.9%; odds ratio=1.89; 95% CI=1.07, 3.35). Combination treatment had a significantly greater effect on abstinence rate in male smokers (odds ratio=4.26; 95% CI=1.73, 10.49) than in female smokers (odds ratio=0.94; 95% CI=0.43, 2.05). It also had a significantly greater effect in highly nicotine-dependent smokers (odds ratio=3.51, 95% CI=1.64, 7.51) than in smokers with lower levels of dependence (odds ratio=0.71, 95% CI=0.28, 1.80). CONCLUSIONS Among smokers who did not show a sufficient initial response to prequit nicotine patch treatment, combination treatment with varenicline and bupropion proved more efficacious than varenicline alone for male smokers and for smokers with a high degree of nicotine dependence.

Duke Scholars

Published In

American Journal of Psychiatry

DOI

EISSN

1535-7228

ISSN

0002-953X

Publication Date

June 17, 2014

Publisher

American Psychiatric Association

Related Subject Headings

  • Psychiatry
  • 5203 Clinical and health psychology
  • 3202 Clinical sciences
  • 17 Psychology and Cognitive Sciences
  • 11 Medical and Health Sciences
 

Citation

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MLA
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Rose, J. E., & Behm, F. M. (2014). Combination Treatment With Varenicline and Bupropion in an Adaptive Smoking Cessation Paradigm. American Journal of Psychiatry. https://doi.org/10.1176/appi.ajp.2014
Rose, J. E., and F. M. Behm. “Combination Treatment With Varenicline and Bupropion in an Adaptive Smoking Cessation Paradigm.” American Journal of Psychiatry, June 17, 2014. https://doi.org/10.1176/appi.ajp.2014.
Rose JE, Behm FM. Combination Treatment With Varenicline and Bupropion in an Adaptive Smoking Cessation Paradigm. American Journal of Psychiatry. 2014 Jun 17;
Rose, J. E., and F. M. Behm. “Combination Treatment With Varenicline and Bupropion in an Adaptive Smoking Cessation Paradigm.” American Journal of Psychiatry, American Psychiatric Association, June 2014. Manual, doi:10.1176/appi.ajp.2014.
Rose JE, Behm FM. Combination Treatment With Varenicline and Bupropion in an Adaptive Smoking Cessation Paradigm. American Journal of Psychiatry. American Psychiatric Association; 2014 Jun 17;
Journal cover image

Published In

American Journal of Psychiatry

DOI

EISSN

1535-7228

ISSN

0002-953X

Publication Date

June 17, 2014

Publisher

American Psychiatric Association

Related Subject Headings

  • Psychiatry
  • 5203 Clinical and health psychology
  • 3202 Clinical sciences
  • 17 Psychology and Cognitive Sciences
  • 11 Medical and Health Sciences