Can I become addicted to any of the drugs used to assist a person to quit smoking?
It is estimated that 1.5 to 2 million Americans try the nicotine gum each year. Thanks to the gum, many people have successfully kicked the cigarette habit. However, some ex-smokers have weaned themselves from one nicotine habit only to pick up a new addiction, but a less risky one. GlaxoSmithKline, manufacturers of Nicorette gum, advises people to stop using the nicotine gum at the end of 12 weeks, and to talk to a doctor if you need to continue to use the gum. But these guidelines haven't stopped some people from using the gum for many months and even years.
In a recent report evaluating data collected by A.C. Nielsen, researchers concluded that 5% to 9% of nicotine gum users relied on nicotine gum longer than the recommended three months. About half of the people in the study used it for six months or longer. In published studies at the Mayo Clinic Nicotine Dependence Center, people have used nicotine gum up to five years without heart or vascular problems. By chewing the gum, the nicotine is delivered slowly through the mucous membranes in the mouth, at much lower levels than the quick-hit surge of nicotine when puffing on cigarettes. At the same time, the gum does not contain any of the cancer-causing substances present in cigarettes. The cancers and vascular diseases associated with smoking develop from the carcinogens, tars, and the carbon monoxide in cigarettes.
What is Bupropion SR?
Bupropion is also known as Zyban or Wellbutrin. Zyban is the trade name for the medication when it is prescribed for smoking cessation and Wellbutrin is the trade name for the medication when it is prescribed for depression. It is therefore classified as an antidepressant. Bupropion works by blocking the dopamine transporter pump preventing the transport of dopamine back into the neuron, and thereby increasing the amount of dopamine in the synaptic cleft (see Question 8).
Dopamine is a neurotransmitter found in the brain that is involved in attention, decision making, motor activity, mood, and the generation of psychoses. It is also the major reward chemical thought to be involved in all forms of addiction. (Questions 10 and 32 discuss nicotine's effects on dopamine.) Bupropion comes in two forms of tablets to be taken by mouth: a regular tablet and a sustained-release or extended-release (long-acting) tablet. The regular tablet (Wellbutrin) is usually taken three or four times a day, with doses at least six hours apart. The sustained-release tablet (Wellbutrin SR or Zyban) is usually taken once or twice daily in the morning and afternoon.
Your doctor will probably start you on a low dose of bupropion and gradually increase the dose over time.
It may take four weeks or longer before you feel the full benefit of bupropion.
Continue to take bupropion even if you feel well. Do not stop taking bupropion without talking to your doctor.
Your doctor will probably decrease the dose gradually over a period of two weeks prior to stopping the medication.
If you forget, skip, or miss a dose, then continue your regular dosing schedule. Do not take a double dose to make up for a missed dose.
Always allow the full scheduled amount of time to pass between doses of bupropion.
Your doctor may need to change the doses of your medications or monitor you carefully for any pre-existing conditions.
There are a number of conditions for which you should not be taking this medication, including if you have a seizure disorder. If you have anorexia or if you have liver disease you should let your doctor know, as these are general contraindications to taking this medication If you experience a serious side effect, you or your doctor should send a report to the Food and Drug Administration's (FDA) Medwatch Adverse Event Reporting program online (at fda.gov/MedWatch/report. htm) or by phone (1-800-332-1088).
If you are taking the sustained or extended-release tablet, you may notice something that looks like a tablet in your stool. This is just the empty tablet casing and does not mean that you did not get your complete dose of medication.
-  A condition or factor that increases the risk of an adverse event when taking a particular medication or receiving a particular treatment.