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Review: bupropion increases abstinence from smoking without affecting mental state in people with schizophrenia

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Question

Question

Is bupropion safe and effective for achieving abstinence from smoking and reducing nicotine dependence in people with schizophrenia?

Outcomes

Smoking cessation at the end of treatment and at 6 months after the start of treatment: measured by self-report and/or biochemical verification (expired carbon monoxide (CO) level); reduction in nicotine dependence at the end of treatment and at 6 months (measured by change in expired CO level and self-reported number of cigarettes smoked, and other biochemical measurements such as serum cotinine levels); change in positive, negative and depressive symptoms at the end of treatment measured using validated tools; adverse events.

Methods

Design

Systematic review with meta-analysis.

Data sources

Cochrane Central Register of Controlled trials, MEDLINE, EMBASE and PsycINFO, from inception to 7 March 2009. Reference lists of relevant studies were also searched to identify unpublished studies, conference abstracts and trial records held by GlaxoSmithKline (manufacturer of bupropion).

Study selection and analysis

Randomised clinical trials (RCTs) comparing bupropion, alone or combined with other pharmacological or non-pharmacological treatments, versus control in adult smokers with schizophrenia (ICD-10 or DSM-IV criteria) were included. Studies involving people with schizophrenia who had nicotine addiction and co-morbid substance abuse disorders were also included. One of the authors searched the databases; two of the authors reviewed the retrieved publications and independently abstracted data from included studies. Authors of the studies were contacted to obtain …

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