Bupropion (Zyban)

Overview

Bupropion (Zyban) is a prescription medication classified as a type of antidepressant. An extended-release form of bupropion is approved for smoking cessation.

Unlike nicotine replacement therapy, bupropion doesn't contain nicotine. It's thought to decrease tobacco cravings and withdrawal symptoms by increasing the levels of certain brain chemicals.

It takes five to seven days for bupropion to achieve effective levels in the blood. You typically should start taking bupropion a week or two before you quit smoking.

Pros

Bupropion:

• Is a pill, so it's relatively easy to use
• Can be used in combination with any nicotine replacement medication
• May reduce the weight gain many smokers experience after quitting cigarettes

Cons

Bupropion:

• Is available only by prescription.
• Must be taken twice a day.
• Can cause dry mouth and insomnia, which tend to ease over time.
• Can cause agitation, depressed mood or suicidal thoughts. If you experience these adverse effects, stop taking the medication and see your doctor.

Cautions

In 2009, the FDA required bupropion to carry a warning that some people experienced serious mental health problems either while taking it or after stopping it, including an increased risk of suicidal thoughts or behavior, hostility, and depression.

In 2016, the FDA reversed that decision based on the results of a large scientific study that found the risk of these mental health side effects was lower than expected. Thus, the FDA determined that the benefits of stopping smoking appear to outweigh the risk of side effects from the medication.

If you take bupropion, report any changes in mood or behavior to your doctor immediately and stop taking the medication.

Bupropion also isn't appropriate if you have seizures or an eating disorder.

Timeline

Bupropion is generally used for 12 weeks. But if you've successfully quit smoking, you can use it for another three to six months to reduce the risk of a smoking relapse.