For Those Trying to Quit, Antidepressant Shows Promise

Medically Reviewed by Jacqueline Brooks, MBBCH, MRCPsych
From the WebMD Archives

May 22, 2001 -- If you're a smoker, you already know you should quit. You've probably tried, at least once. Maybe you wore a patch or chewed nicotine gum. You suffered cravings, mood swings, and weight gain -- only to break down and light up again.

Well, you might want to give it another shot. And this time, take Zyban. Research shows the antidepressant can really boost your odds at getting -- and staying -- tobacco-free.

"Zyban, along with counseling and patient education, is of great value in this arena," says David A. Meyerson, MD, a cardiologist at Johns Hopkins University in Baltimore and national spokesman for the American Heart Association. "It makes the enormous, horrible cravings less intense and wider apart, so they are much more tolerable."

In a multicenter trial led by Lowell C. Dale, MD, of the Mayo Clinic, researchers assigned more than 600 adult smokers, each of whom smoked at least 15 cigarettes a day, to receive either low-, medium-, or high-dose Zyban, or an identical-looking but inactive placebo pill, for seven weeks. They then followed the subjects for another 45 weeks to see who remained abstinent and who went back to smoking.

One year after starting treatment, smokers who had taken Zyban, especially at the highest dose, were more likely to be smoke-free than the people who'd taken a placebo. The researchers could not identify any personal characteristics that made Zyban ineffective -- that is, it appeared to work for just about everyone.

But if you do choose to take Zyban, some of you will do better than others.

Those in the study who were most successful were male, older, or comparatively light smokers or had no other smokers in their household. Other factors linked to success include remaining smoke-free during the first two weeks of the trial and having made attempts at quitting in the past.

Zyban can definitely help, but it's unlikely to be enough on its own, says Meyerson. The real keys to success are motivation and education.

"[Medication] is of no value unless the person is motivated," he tells WebMD. But doctors have less time than ever and are often inadequately trained to counsel and educate on smoking cessation. Therefore you, the smoker, need to get out there and arm yourself with information and support, he says.

There is no doubt of the enormous health benefits of quitting, says Meyerson. "As a cardiologist, I can tell you that there is no medication or operation that will add more years to your life than quitting smoking. It's critical."

And simply cutting down won't cut it.

"With regard to preventing heart attack and stroke, cutting down on cigarettes is like saying that you only drive 135 miles per hour three times a week," he says. "It's not enough. You must quit, completely."

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