Bupropion, counseling may help youth with ADHD stop smoking

May 03, 2004

Results of a small pilot study suggest that combining the drug bupropion with brief counseling sessions may help teens reduce or stop smoking, even those with attention deficit hyperactivity disorder (ADHD). Evidence suggests that people with ADHD have more difficulty quitting smoking than people who do not have the disorder.

Bupropion is known commonly as Zyban or Wellbutrin.

Researchers at the Medical University of S. Carolina in Charleston enrolled 16 adolescents, aged 12 to 19 years, in the study. Participants took the drug at the maximum dosage of 300 mg daily for 6 weeks. They also took part in two 30-minute smoking cessation counseling sessions. Eleven of the 16 youths had co-occurring ADHD.

The scientists say that the number of cigarettes the participants smoked daily decreased significantly from an average of more than 18 at the start of the study to less than 1 when the study ended. Five participants, one of whom had ADHD, quit smoking by the fourth week of the study.

The researchers also assessed levels of carbon monoxide (CO) in expired breath to gauge the efficacy of the program. Levels of CO decreased significantly, falling from a baseline of about 18 parts per million (ppm) to about 7.2 ppm by the end of the study. CO, a component of cigarette smoke, reduces the capacity of blood to carry oxygen, forcing the heart to work harder to supply the body with the oxygen it needs. Decreased levels of CO may signify the efficacy of a smoking cessation program.

There was no change in ADHD symptom scores among the participants who completed the study.

WHAT IT MEANS: These results suggest that bupropion might have a role in treating nicotine dependence in adolescents. In light of the limited options available for treating nicotine dependence in youth, future studies of the efficacy of bupropion that are randomized, double-blinded, and placebo-controlled may be warranted.

Dr. Himanshu Upadhyaya and his colleagues published this study in the February 2004 issue of Journal of the American Academy of Child and Adolescent Psychiatry.

NIH/National Institute on Drug Abuse

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