What Should I Know About Zyban as a Quit Aid?

Zyban® is the brand name for the generic drug bupropion hydrochloride. It is a nicotine-free quit aid.

Originally marketed as an anti-depressant drug under the brand name of Wellbutrin, it became apparent that bupropion was an effective quit aid because smokers using it to treat depression also lost interest in smoking. People not planning to quit smoking found themselves stopping with relative ease.

Later, bupropion hydrochloride was given the brand name of Zyban and in 1997, the FDA approved it as a quit smoking aid.  When used in combination with nicotine replacement therapy (NRTs), the chance for long-term success with smoking cessation increases.

Note:  it is important to be monitored by your doctor if you're using both Zyban and an NRT as high blood pressure can be a concern.

How Does Zyban Work?

It isn't completely understood how Zyban works, but we do know that it alters brain chemistry in such a way that nicotine is rendered less effective. The result is a reduced interest in smoking, and nicotine cravings and withdrawal are minimal.

While this medication was developed as an anti-depressant, you do not need to suffer from depression for it to work as a quit aid.  That said, if you develop quit-related depression, Zyban may help to offset the symptoms.

Where Do I Get Zyban and How Do I Use it?

Zyban is not sold over the counter, so you must see your doctor for a prescription.

To begin with, you take Zyban while you're still smoking.

Days 1 - 3:  One 150 mg tablet once a day.

Days 4 - 7:  One 150 mg tablet twice a day, at least 8 hours apart.

It's a good idea to space your pills out so that the second pill of the day is several hours before bedtime as bupropion can make it hard to get to sleep.

Week 2:  Continue to take one pill twice a day, at least 8 hours apart. Stop smoking during week two, on the day you picked to quit.

Week 3 and beyond:  Continue as with week 2. The recommended course of treatment is 7 weeks, but it can be taken for a longer period of time. Your doctor will help you decide when you should stop treatment.

If you're unable to stop smoking by the end of week 3, your doctor may discontinue this medication as it might not be a good fit for you as a quit aid.  If that happens, don't worry. There are several other options on the market today that could work better for you.

Very Important:  If you miss a dose and it's close to time for the next one, skip that pill. Never take a double dose to catch up as this could increase the risk for seizures.

If you take too much Zyban accidentally, call your doctor, poison control or go to an emergency room at your local hospital immediately, even if you're not experiencing anything out of the ordinary.

Also, never stop taking this drug abruptly, unless you have one of the side effects in the section below where that is recommended. Consult with your doctor immediately if this happens.

Who Should Not Use Zyban

Zyban isn't suitable for everyone.

 Avoid it if:

• you use any other drug containing bupropion hydrochloride
• you have or have had a seizure disorder
• you have or have had an eating disorder
• you are taking or have recently taken a monoamine oxidase inhibitor (MAOI)
• you are pregnant or nursing
• you are allergic to burproion hydrochloride
• you are abruptly discontinuing alcohol or sedatives(including benzodiazepines)

Common Side Effects of Bupropion

• dry mouth
• dizziness
• insomnia
• change in appetite
• change in sense of taste
• weight loss
• stomach pain
• nausea
• vomiting
• anxiety
• excitement
• headaches
• stuffy nose
• uncontrollable shaking in a part of the body
• ringing in the ears

• sore throat
• excessive sweating
• frequent urination

If any of the above side effects become severe or don't go away, see your doctor.

Side Effects You Should Seek Immediate Medical Attention For:

• seizures
• hallucinations
• confusion
• irrational fears
• rapid, pounding or irregular heart rate
• muscle or joint pain

Side Effects That Warrant Stopping Zyban Immediately:

• rash or blisters
• fever
• itching
• swelling of the face, throat, tongue, lips, eyes, hands, lower legs
• hoarseness
• difficulty breathing or swallowing
• chest pain.

If you experience any of these side effects, discontinue Zyban and see your doctor or go to an emergency room right away.

In 2009, the U.S. Food and Drug Administration required the makers of Zyban and Chantix, a similar quit aid to post a warning on product packaging about potentially severe side effects.

If you have any problems not listed here that are troublesome and you're concerned about whether they might be related to Zyban, check in with your doctor as soon as possible.

How Effective Is Zyban?

Of the small number of studies done on Zyban efficacy over the years, success rates seem to be in the 30% range for people who are smoke-free at the one year mark.  However, the figures for people who have not smoked any cigarettes during the entire year drop to about 18%, or about one in five.  When used with NRTs however, the rate climbs slightly to approximately 22% for those who didn't smoke at all during the first year.

More importantly perhaps is how effective Zyban can be when you couple it with a good support group of like-minded individuals for smoking cessation.  Whether online or in person, support may be the single most important quit tool you can employ. 

_Sources:

_{U.S. Food and Drug Administration. GlaxoSmithKline Zyban Medication Guide. http://www.fda.gov/downloads/Drugs/DrugSafety/ucm089835.pdf.}

_{Action on Smoking and Health. Efficacy of Zyban and NRT. http://ash.org.uk/files/documents/ASH_444.pdf}

_{Medscape.govt.nz. Zyban Consumer Medicine Information. http://www.medsafe.govt.nz/consumers/cmi/z/zyban.pdf.}