Quitting smoking: Can an antidepressant improve the success rate?

People who want to quit smoking can increase their chances of short-term success if they use the antidepressant bupropion. But adverse effects are common, so the use of antidepressants needs to be carefully considered.

Many smokers want to quit smoking, or they have already tried to quit once or even often. The problem is, it is not easy to stay off cigarettes. There are some ways to increase the chances of success, though, especially using nicotine replacement therapy (NRT) such as nicotine patches or gum. You can read more about NRT in our Fact Sheet and research summary. Because NRT also has limited success, researchers have tried to find other options.

One of these options is the group of drugs called antidepressants. They are drugs that are used to try to reduce depression. Some of these drugs have been tested to see if they can help people quit smoking. To see what the state of the evidence is, researchers from the Cochrane Collaboration looked for trials where anti-depressants were tested for quitting smoking.

After evaluating 36 trials, the researchers came to the conclusion that there is no evidence to show that most types of antidepressants are suitable for quitting smoking. They did find some trials that provided evidence that two types might be able to help people give up smoking. However only one of those, bupropion, is widely approved for use for quitting smoking internationally, including in Germany.

The results: out of 10 smokers who used bupropion, about 8 went back to smoking (80%). In comparison, out of 10 smokers who did not use bupropion, about 9 had started smoking again after 6 to 12 months. In other words, the drug had helped an extra 1 out of 10 smokers to quit. This means that the drug doubled the chances of successfully quitting.

In deciding whether or not to use antidepressants, though, the question of adverse effects plays an important role. The use of bupropion caused insomnia in about 1 in 10 people (10%). Other adverse effects were dry mouth and nausea. There is also a small increased risk of seizures. Using this drug might be dangerous for people at a high risk of having seizures. Because there can sometimes be serious adverse effects, the Cochrane researchers suggest that the use of bupropion for quitting smoking needs to be carefully considered.

© IQWiG (Institute for Quality and Efficiency in Health Care)