Sustained release bupropion (amfebutamone) is a non-nicotine agent that is 
indicated as an aid to smoking cessation. In 2 large well designed clinical 
trials, sustained release bupropion 300 mg/day (the recommended dose) for 7 or 9 
weeks was associated with considerably and significantly higher smoking 
abstinence rates (continuous abstinence and 7-day point prevalence rates) than 
placebo during treatment and at follow-up at 6 and 12 months. Point prevalence 
rates at 12 months in 2 studies were 23.1 and 30.3% with bupropion, whereas 
values for placebo were 12.4 and 15.6%. Continuous abstinence rates at 12 
months, available from 1 trial, were 18.4% with bupropion and 5.6% with placebo. 
Furthermore, bupropion was associated with significantly higher quitting rates 
than nicotine patch in a comparative study. Combination therapy with bupropion 
and nicotine patch provided slightly higher abstinence rates than bupropion 
alone, although differences were not statistically significant. The combination 
was superior to nicotine patch alone. Data from a preliminary report of long 
term bupropion treatment (52 weeks) showed that the drug was associated with 
significantly higher continuous abstinence rates than placebo only to 6 months. 
However, point prevalence abstinence rates were significantly higher with 
bupropion than placebo to 18 months. Bupropion 300 mg/day recipients reported 
nicotine withdrawal symptoms during treatment; however, the symptoms were 
significantly less severe with bupropion than placebo. Patients receiving 
bupropion 300 mg/day or bupropion in combination with nicotine patch for smoking 
cessation generally gained less bodyweight than placebo recipients. The benefits 
of bupropion for preventing weight gain persisted after the completion of long 
term, but not short term therapy. Bupropion was well tolerated in clinical 
trials, and the only adverse events that were significantly more common with 
bupropion than placebo were insomnia and dry mouth. Data published so far 
suggest that sustained release bupropion has a low potential for inducing 
seizures (seizure rate approximately 0.1% in patients with depression).
CONCLUSIONS: Bupropion is an effective and well tolerated smoking cessation 
intervention. Further studies with long term follow-up will be useful in 
determining whether abstinence rates are maintained with bupropion. In addition, 
clarification of its efficacy in comparison with other therapies used for 
smoking cessation would help to establish its clinical value. The reduced 
potential for weight gain with bupropion and the ability to use bupropion in 
combination with nicotine replacement therapy make the drug a useful treatment 
option for smoking cessation.