Center for Addiction Medicine

01/06/2011

SMOKING CESSATION MEDICATIONS

In the online edition of the January 3, 2011 issue of Archives of General Psychiatry is an article discussing brain-imaging studies comparing the effectiveness of two commonly used medications for nicotine cessation. These medications are bupropion (Zyban) and varenicline (Chantix), and each appear to change the way the brains of nicotine-dependent smokers react to smoking cues.

In the first study conducted by UCLA researchers, 30 smokers were randomly assigned bupropion or placebo for 8 weeks. At the end of the study, the bupropion group reported fewer self-reported cravings after exposure to smoking cues and had decreased activation in the limbic and prefrontal cortex measured by functional magnetic residence imagery (fMRI). “In our study, the bupropion-treated group had less activation in the ventral striatum, which is the reward area of the brain; The orbitofrontal cortex, which is an area of the brain associated with repetitive thoughts; and the singular cortex, which is sort of an anxiety arousal center of the brain,” explained investigator Dr. Arthur Brody.

In the second study of 22 smokers conducted by a different research group across the country randomly assigned varenicline or placebo showed similar results in reducing brain activation in craving-related areas. Varenicline is also known for reduction of nicotine withdrawal symptoms and, in this study, self-reported cravings in response to smoking cues were reduced. Dr. Theresa Franklin, lead study author in the second study stated “ For many smokers, when they see smoking cues, it means reward, and it’s very hard for them to turn on their stop system. So these medications will help.” Dr. Franklin also stated “Both varenicline and bupropion have been shown now to decrease cue reactivity and to help people say no.”

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