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The association of bupropion and nicotine is a good choice in the treatment of smoking cessation. However, not all patients actually give up smoking. STUDY OBJECTIVES: This work was undertaken with the aim of finding out the functional or clinical variables that could be associated with the success of the cessation therapy. DESIGN: In one year, 88 patients who were treated with bupropion 300 mg/day and nicotine patches were followed-up, for 1 month and 3 months, respectively. They were all questioned about the number of cigarettes per day, the years they have been smoking, the number of quitting attempts, and concurrent pulmonary conditions were sought for. The Fagestrom Test, forced spirometry (FVC, FEV-1, FEF25-75), and exhaled carbon monoxide (by co-oxymetry) were also assessed. For the statistical analysis, a logistic regression model allowing to predict the response of new subjects to the treatment, with the lowest error possible, was applied. To choose the working model, the highest and lowest value of each variable were found, drawing the correlation matrix between dependent and independent variables, by means of the box-plot procedure. Then, the model's application conditions were analysed: linearity, homoscedasticity, independence of the applications, and normality of the distributions. To assess the discrimination of the model, a ROC curve was used. RESULTS: Showed that at the end of the follow-up year, 59.1% of the patients quitted smoking. The multivariate analysis with logistic regression showed that no previous history of chronic obstructive pulmonary disease (COPD), a FEF25-75 value and effectively quit after the first week of treatment were independent prognostic factors of treatment success. When the diagnosis precision of our model was analysed by means of the ROC curve, it showed a 78% value, with the 95% confidence interval ranging from 68.5% to 86.9%. At the optimal cut-off point of our model, sensitivity and specificity for quitting smoking were found to be 66.7% and 80%, respectively. CONCLUSIONS: We conclude that with a diagnosis precision of 78.8% patients with no history of COPD, who quitted at the first week of therapy with bupropion and with low FEF25-75, will remain non-smokers after one year follow-up. Contrarily, COPD patients who still smoke after one week of therapy, will not achieve quitting smoking.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14635510&dopt=Abstract
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Prim Care. 1991 Jun;18(2):421-33.
Treatment of depression. New pharmacologic approaches.
Calabrese JR, Markovitz PJ.
Department of Psychiatry, University Hospitals of Cleveland, Case Western Reserve University School of Medicine, Ohio.
Recurrent major depression is an underdiagnosed, undertreated mood disorder that affects approximately 10 million Americans. Although the tricyclic antidepressants are the oldest and best studied class of antidepressant medications available, their use is routinely compromised by unsatisfactory pharmacokinetic and side-effect profiles. The newer antidepressant medications have longer half-lives and are less likely to produce side effects. The prototypes of the newer antidepressants are bupropion (Wellbutrin) and fluoxetine (Prozac). Fluoxetine distinguishes itself in that its half-life is 2 to 3 days, whereas the mean half-life of buproprion and the tricyclics are 10 to 14 hours. For this reason, fluoxetine is routinely administered once daily in the morning. Both of these agents bind to the cholinergic, histaminergic, and alpha-1 adrenergic receptors with minimal affinity, and are less likely to yield clinically significant side effects. The use of the newer antidepressants has led to improved patient compliance and physician acceptance.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1876622&dopt=Abstract
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Drug Alcohol Depend. 1990 Aug;26(1):9-17.
Substitution of psychoactive drugs in pentobarbital-dependent rats.
Yutrzenka GJ, Patrick GA, Rosenberger W.
Department of Physiology and Pharmacology, University of South Dakota School of Medicine, Vermillion.
The substitution of either bromazepam, diazepam, methaqualone, mazindol, nortriptyline or bupropion for pentobarbital, in dependent rats, was assessed using a continuous drug infusion method. Male, Sprague-Dawley rats were made dependent on pentobarbital during 12 days of continuous, intraperitoneal, pentobarbital infusion. On Day 13, pentobarbital was replaced with either saline, vehicle, or one of the drugs of interest and rats were infused for 24 h. On Day 14, all rats were infused, for 24 h, with saline. Changes in both body weight and behavioral indices of withdrawal were assessed during Day 13 and 14. It was observed that bromazepam and methaqualone substituted for pentobarbital in a dose-dependent fashion. Diazepam also substituted in pentobarbital dependent rats but, inexplicably, the low dose of diazepam provided better substitution than did the higher dose. On the other hand, neither mazindol or nortriptyline substituted for pentobarbital and there was a tendency for exacerbation of the withdrawal signs. Finally, it was noted that the low dose of bupropion appeared to decrease the severity of the withdrawal symptoms. The data supports the view that the substitution of compounds for pentobarbital, in dependent rats, is limited to those compounds which, presumably, possess similar mechanisms of action in the CNS.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2120023&dopt=Abstract
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