Drugs online research references
Prescrire Int. 2001 Dec;10(56):163-7.
Amfebutamone/bupropion for smoking cessation: new preparation. Nicotine replacement therapy is safer.
[No authors listed]
(1) For smokers who want to quit and who qualify for pharmacological support, the various forms of nicotine replacement therapy available in France yield a one-year cessation rate of about 14-18%, compared to about 10% with placebo. (2) Amfebutamone (also known as bupropion) is structurally related to an amphetamine psychostimulant. (3) The clinical file mainly contains data from a dose-finding study, two placebo-controlled trials, and a trial comparing amfebutamone + transdermal nicotine with amfebutamone + transdermal placebo. (4) It has not yet been shown that the approved dose regimen of 300 mg/day is more effective than 150 mg/day, or that the treatment period of 7-9 weeks is optimal. (5) Compared to placebo, the one-year cessation rate was only about 13% higher (absolute value) in one trial, much less in the dose-finding study (3%), and not determined in the other two trials. The trial comparing amfebutamone with nicotine suffers from too many methodological weaknesses to show any difference in the efficacy of the two drugs. There has been no specific assessment of amfebutamone in patients with coronary heart disease. (6) There is no basis for combining amfebutamone with nicotine replacement therapy, as there is no evidence of higher efficacy. Furthermore, cardiovascular risk may be increased. (7) Amfebutamone can have serious adverse effects: the estimated risk is approximately 0.1% for convulsions and 3% for potentially severe hypersensitivity reactions. The adverse effects seem to be similar to those of appetite-suppressant amphetamines, including insomnia, weight loss and hypertension. The possible risk of heart valve disease has not been ruled out, because echocardiographic follow-up studies have not been done. (8) Potential adverse effects and drug interactions should contraindicate the use of amfebutamone by patients with a history of cardiovascular, neurological or psychiatric disorders. (9) In practice, when someone needs drug support to quit smoking, nicotine replacement therapy should be tried first.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11824437&dopt=Abstract
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Am J Drug Alcohol Abuse. 2002;28(1):189-96.
Open-label pilot study of bupropion plus bromocriptine for treatment of cocaine dependence.
Montoya ID, Preston KL, Rothman R, Gorelick DA.
Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, USA.
Combinations of medications are often used in neuropsychiatry to enhance treatment efficacy. This 8-week, open-label study tested the combination of bupropion (< or =300 mg) and bromocriptine (< or =7.5 mg) daily in 34 cocaine-dependent (DSM-IIIR) outpatients also receiving weekly individual counseling. The first 18 subjects spent one week at maximum dose; the next 16 spent three weeks. Both groups showed significant reductions in self-reported cocaine use, with no significant change in proportion of urine toxicology tests positive for cocaine. There were no significant differences in outcome between groups. These results suggest that the combination of bupropion and bromocriptine is safe in cocaine addicts, but provide ambiguous evidence of its efficacy.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11853133&dopt=Abstract
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Tex Dent J. 2000 Jun;117(6):26-32.
Treatment of nicotine addiction.
Jones DL, Mobley CC.
Department of Public Health Sciences, Baylor College of Dentistry/TAMHSC, Dallas, Texas, USA.
The best available data show smoking to be by far the most important cause of disease and death in our society, contributing to an average of 1000 deaths every day. Although a large majority of current smokers express a desire to quit, the majority of "self-help" attempts to quit are not successful. Further, most smokers indicate never having received advice on cessation from healthcare providers. The combination of pharmacotherapy and behavioral interventions, even on a minimal level, have been shown to be effective in cessation. Such strategies are certainly highly cost-effective, given the enormous costs to society of smoking-related illnesses. Therefore, it is important that all healthcare providers provide at least some form of smoking cessation programs for their patients.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11857853&dopt=Abstract
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