Zyban - a new treatment for nicotine addiction
Zyban is a drug marketed by Glaxo-Wellcome and has been used, very successfully, to treat nicotine addiction directly. In this case it is different to the way other anti-smoking agents work, such as nicotine gum and patches, since these simply supply an alternative source of nicotine other than cigarettes. Zyban works at the neurological level, reducing the craving for nicotine in any form. At the moment it is licensed in the US, but not yet in the UK. It is potentially extremely important, as this discovery could open the door to finding similar molecules for treating much more serious addiction problems, such as cocaine and heroin, etc.

The active ingredient in Zyban is bupropion, a relatively weak inhibitor of the neuronal uptake of dopamine, serotonin and norepinephrine. Chemically, bupropion is related to phenylethylamines and has a relative molecular weight of 276.2. Although, bupropion was initially marketed as an anti-depressant (Wellbutrin), it is chemically unrelated to tricyclic, tetracyclic, selective serotonin reuptake inhibitors or other known anti-depressants.

The pharmacokinetics of bupropion is best described by a two-compartment model with a distribution phase (how long it takes for the drug to be absorbed into the body and begin working) having a mean half-life of 3-4 hours, and an elimination phase (how long it takes for it to be metabolised and broken down to inert waste products) which has a half-life of 21 hours. Bupropion is extensively metabolized into three active metabolites. At least one of these metabolites is formed by an enzyme called cytochrome P-450 2B6 enzyme. The terminal half-life of the three metabolites ranges from 21 to 37 hours. This means that it may interact with other drugs which also effect this enzyme, such as orphenadrine and cyclophosphamide. The main known side-effects of zyban are dry mouth and dizziness, although there are a few others.

Treatment method
The recommended and maximum dose of Zyban is 300 mg/day given as 150 mg tablets, twice daily. Treatment is usually initiated while the patient is still smoking and the target date for smoking cessation is normally within the first two weeks of Zyban treatment. Zyban therapy then continues for 7 to 12 weeks, depending on the effect of the therapy. If the patient has not reduced smoking by the seventh week of Zyban therapy, it is unlikely that he/she will quit during that attempt and Zyban therapy is normally discontinued.

Zyban.com:"ZYBAN is a Totally Different Way To Help You Quit Smoking. Nicotine-Free ZYBAN is prescription-strength medicine. ZYBAN is the first nicotine-free pill approved to help you quit smoking and is available from your health care professional. The first pill that can help reduce your urge to smoke. Users of ZYBAN also get The ZYBAN Advantage Plan® at no additional cost with a prescription for ZYBAN. This support system provides information to help you during the quitting process. And you can now enroll on-line and receive all your materials on the Internet."
http://www.zyban.com/

Zyban for smoking cessation:"Bupropion looks better than nicotine replacement therapy. The placebo response rate is the same, but cessation rates are higher, and the NNT, at 8, is lower than that for most nicotine replacement therapies, at about 12-15 (Bandolier 54 ). Given that the smoking of cigarettes has such major health consequences ( Bandolier 9, 14), clearly there will be benefits for some people. Smokers don't have to be depressed to use bupropion. There are adverse effects, and the review [1] quotes a risk of seizures estimated at 1 in 1000, as well as minor adverse effects like nausea and insomnia, but without numbers."
http://www.jr2.ox.ac.uk/bandolier/band79/b79-3.html

Drug Information - Zyban


Generic Name: Bupropion (byoo-PROE-pee-on)

This medicine is a smoking cessation aid used to help you stop smoking.



Some medicines or medical conditions may interact with this medicine. Inform your doctor or pahrmacist of all prescription and over-the-counter medicine that you are taking. Do not use this medicine if you are also taking HIV protease inhibitors or a monoamine oxidase inhibitor (MAOI). Additional monitoring of your dose or condition may be needed if you are taking tramadol. Inform your doctor of any other medical conditions, allergies, pregnancy, or breast-feeding. Use of this medicine is not recommended if you have a history of muscle or nerve conditions or seizures. Contact your doctor or pharmacist if you have any questions or concerns about using this medicine.
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Follow the directions for using this medicine provided by your doctor. This medicine comes with a patient information leaflet. Read it carefully. Ask your doctor, nurse, or pharmacist any questions that you may have about this medicine. Swallow whole. Do not break, crush, or chew before swallowing. If you are taking more than 1 dose each day, allow at least 8 hours between doses. Store this medicine at room temperature, away from heat and light. If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
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It takes 1 week for this medicine to work. Do not stop taking this medicine without checking with your doctor. During the first week of taking this medicine you should continue to smoke. You should plan to stop smoking during the second week of taking this medicine. This medicine may cause dizziness or a change in vision. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to this medicine. Do not drink alcohol while you are taking this medicine. Before you begin taking any new medicine, either prescription or over-the-counter, check with your doctor or pharmacist. For women: this medicine is excreted in breast milk. Do not breast-feed while taking this medicine.

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