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Efficacy and safety of bupropion for smoking cessation and reduction in schizophrenia: systematic review and meta-analysis

  • Daniel Tai-yin Tsoi (a1), Mamta Porwal (a2) and Angela Claire Webster (a3)

Abstract

Background

The benefits and harms of bupropion as an aid for smoking cessation in schizophrenia remain uncertain.

Aims

To summarise the current evidence for efficacy and safety of bupropion as treatment for nicotine dependence in schizophrenia.

Method

Systematic review and random-effects meta-analysis of randomised controlled trials (RCTs) comparing bupropion with placebo or alternative therapeutic control in adult smokers with schizophrenia.

Results

Twenty-one reports from seven RCTs were included. Biochemically verified self-reported smoking cessation rates after bupropion were significantly higher than placebo at the end of treatment (risk ratio (RR) = 2.57, P = 0.004) and at 6 months (RR = 2.78, P = 0.05). Expired carbon monoxide level was significantly lower with bupropion at the end of therapy (P = 0.002) but not at 6 months (P = 0.37). There was no significant difference in positive (P = 0.28) or negative symptoms (P = 0.49) between the bupropion and the placebo group.

Conclusions

Bupropion increases the rates of smoking abstinence in smokers with schizophrenia, without jeopardising their mental state.

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Copyright

Corresponding author

Correspondence: Daniel Tai-yin Tsoi, Division of Psychiatry, A Floor, South Block, Queen's Medical Centre, Nottingham NG7 2UH, UK. Email: t.tsoi@sheffield.ac.uk

Footnotes

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*

This work was presented as a poster at the 17th European Congress of Psychiatry, Lisbon, 2009. An expanded version of the review (including interventions other than bupropion) will appear in the Cochrane Library, issue 6, 2010.

Declaration of interest

None.

Footnotes

References

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Efficacy and safety of bupropion for smoking cessation and reduction in schizophrenia: systematic review and meta-analysis

  • Daniel Tai-yin Tsoi (a1), Mamta Porwal (a2) and Angela Claire Webster (a3)

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Efficacy and safety of bupropion for smoking cessation and reduction in schizophrenia: systematic review and meta-analysis

  • Daniel Tai-yin Tsoi (a1), Mamta Porwal (a2) and Angela Claire Webster (a3)
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