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Quitting With Zyban:

Zyban is an anti-smoking pill that seems to reduce nicotine withdrawal symptoms and the urge to smoke, and it contains no nicotine. The action of the drug is still not fully understood, but it seems to have an effect on the chemicals in the brain associated with nicotine addiction (which include beta-endorphins, acetylcholine, dopamine and norepinephrine). This medication works by affecting noradrenergic and dopaminergic pathways in the brain and thereby relieving the symptoms of depression. It is not known exactly how Zyban works to help people stop smoking.  Bupropion Hydrochloride, its trade name,  is also prescribed for depression and sometimes ADHD. In this version, it is called Wellbutrin. Zyban and Wellbutrin are the same exact medication, Bupropion Hydrochloride, but are marketed differently. The doses used are different because each medication is used to treat different conditions.

Some facts about Zyban:

  • Some common side effects from using Zyban include dry mouth, difficulty sleeping, shakiness and skin rash.

  • About one out of every 1,000 people taking bupropion may have a seizure, which may involve convulsions and loss of consciousness. People should not use Zyban if they have a pre-existing seizure condition such as epilepsy, or an eating disorder such as anorexia nervosa or bulimia, or if they are taking other medications containing Zyban's active ingredient, bupropion hydrochloride. These circumstances can increase the chance of a seizure.

  • Zyban is not recommended for women who are pregnant or breast-feeding.

  • Zyban can be used with a nicotine replacement therapy (NRT), but the supervising physician should monitor the Zyban user closely for a possible rise in blood pressure when it is used with an NRT.

  • It is not physically dangerous to smoke while using Zyban, but continuing to smoke after you decide to stop significantly reduces the chance of successfully quitting.

When Will My Medication Start to Work?: You should start feeling the effects of Zyban within one to two weeks if you are taking the medication to help stop smoking. It may take longer to experience the full effects of Zyban, which depends on dosage and varies from person to person.

Any Other Important Information?: If you are pregnant, plan to become pregnant, or breastfeeding, discuss the potential risks of this or any medication with your doctor.

If you take Zyban, you may be more vulnerable to seizures if your dosage is too high, have suffered brain damage, or have had seizures before. In recent studies, 28% of patients exhibited weight loss of 5 lb. or more (Rybaki & Long, 1998).

Also, many patients experience a period of increased restlessness, especially when first taking the drug. This may take the form of agitation, insomnia, and anxiety.

What are the Side Effects?: Remember that only some people will experience side effects--and that no one experiences side effects in exactly the same way. If you experience any side effects, contact your doctor or clinician right away and continue taking your medication. The following list may not contain all of the side effects associated with this medication:

Most common side effect weight loss, insomnia, nervousness
Infrequent side effects agitation, constipation, dry mouth, headache, nausea, skin problems, tremors, excessive sweating

As many as 3 in 1,000 people taking Zyban may have an allergic reaction--
such as itching, rash and hives--severe enough to require medical attention.

Rare side effects/Risks hypomania, seizures, tinnitus, white blood cell decrease

Are there any Drug Interactions?: Remember, always follow your physician's recommendations on how to take your medication. Even if you are taking one of the following substances, continue taking your medication as prescribed and consult your physician. Also, if you are taking any herbal remedies, vitamins, and/or over-the-counter medications, be sure to tell your physician. The following section offers some, but not necessarily all, of the possible drug interactions.

Avoid excessive use of alcohol; it can increase the risk of seizures. Do not use Zyban and marijuana; there have been cases of induced psychotic behavior. Adverse interactions have been found with other medications such as MAO inhibitors, Levadopa, major tranquilizers such as thorazine, other antidepressants, tagamet, tegretol, and phenobarbital. You may take nicotine patches and take Zyban, however; an increase in blood pressure may occur. Your blood pressure should be monitored if both medications are taken. Do not smoke while using any nicotine product and Zyban; too much nicotine may have serious side effects. Consult your doctor if you have any questions concerning these combinations.

References:

  • Arky, R. M.D. (1998). Physicians' Desk Reference. Montvale, NJ: Medical Economics Data Production Company.

  • Glaxo Wellcome Homepage. Zyban. Available [Online] 11/20/98.

  • Rybacki, J. & Long, J. (1998). The Essential Guide to Prescription Drugs. New York, NY: HarperPerennial.

  • Sifton, D. W. (1997). The PDR Pocket Guide to Prescription Drugs. New York, NY: Simon & Schuster.

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