Is Zyban Right for You?

[historyteach]

Is Zyban Right for You?
Dr. Trudy Manchester, M.D.
Associate Professor of Clinical Medicine - Division of Primary Care and General Medicine, UMASS Memorial HealthCare


Smokers who try to quit on their own are successful about 10% to 12% of the time. Thus, the development of nicotine replacement treatments (patch, gum, inhaler, and nasal spray) was a very important step forward for smokers. Individuals who use any of these treatments are two to three times more likely to be successful. Zyban is the first non-nicotine prescription medication available to help smokers to quit smoking. The generic name for Zyban is bupropion SR. It is also available under the name Wellbutrin.

We don't know exactly how Zyban works but we believe that it has a direct effect on the part of the brain that is addicted to nicotine. It seems to reduce the cravings for cigarettes that smokers experience when they try to quit. It also seems to reduce many of the nicotine withdrawal symptoms that people experience when they quit. Specifically, people who used Zyban to help them quit had less irritability, less frustration, and less anger than people who quit on their own without medication. They also had less difficulty with concentration, less restlessness, and less depression. These same things are true for people who use the nicotine patch or the gum, but Zyban has a different way of working. The patch and the gum provide the nicotine that you would get from smoking whereas Zyban seems to change the way your brain deals with not having nicotine.

Is Zyban better than nicotine replacement therapy? In most studies, it appears that Zyban works as well as the nicotine replacement therapies. It works differently, however, and research is continuing to try to identify which types of smokers would do better with Zyban and which might do better with nicotine replacement. It is very clear from all of the studies on quitting, however, that your chances of being successful depend a great deal on your motivation and commitment to quitting. This is true, no matter what therapy you may choose.

Can anyone use Zyban? No, patients with seizure disorders or eating disorders should not use Zyban, nor should women who are pregnant or breastfeeding. Individuals with allergic reactions to bupropion as well as patients who are treated with monoamine oxidase inhibitor medication (a specific type of antidepressant) should not receive Zyban. In addition to these conditions, caution is advised in many other medical conditions, such as liver disease, kidney disease, hypertension, and any history of brain injury or brain surgery.

How do I take Zyban? It is best to begin Zyban one to two weeks before your actual quit date. You will begin with one tablet per day for the first three days and then increase to one tablet two times per day on the fourth day. These two doses must be at least eight hours apart. It takes about one week for the Zyban to reach the right levels in your system, so you should plan a specific quit date at some point in the second week of therapy. If you realize that you have missed a dose, you should NOT take an extra dose.

How long do I need to take Zyban? If all goes well and you are successful in quitting, you should plan to stay on the Zyban for 7 to 12 weeks. Your primary care provider may recommend a longer course of treatment, however, depending on your unique circumstances. If you continue to have difficulty in giving up cigarettes after about 7 weeks of Zyban treatment, it is best simply to stop the Zyban and then try again at another time. You should discuss this with your physician, so that you can determine what might have gone wrong and make better plans for the next quit attempt.

What about side effects? As with all prescription medications, there are many possible side effects from Zyban. The most common ones are dry mouth and difficulty with sleep. Drinking water, using throat lozenges, and chewing gum may all help with the dry mouth. If you have trouble with sleep, you can try taking your second Zyban dose earlier in the day. (Remember that you must allow at least 8 hours between the first and the second dose, however.) You should also reduce your caffeine intake if sleeping is difficult. Don't let these possible side effects scare you. Most people do NOT have side effects. If side effects do occur, they can usually be minimized by simple means. And side effects are temporary - they last only as long as you are on a medication and not for the rest of your life. Putting up with mild side effects for a short while is a small price to pay if you ultimately can free yourself from smoking!

Is Zyban right for me? The best way to determine this is to visit your primary care provider to review all of your options for treatment. Together you can select the best therapy for you and monitor your progress. If you are committed to quitting, work closely with your primary care provider, and use any form of medication, then you will be well on your way to becoming a non-smoker!

"...your chances of being successful depend a great deal on your motivation and commitment to quitting."

Hope this helps!
Shalom!

[sisterofD]

Hi Teach, I was wondering have you felt any extra anxiety while taking your zyban? I am on my 4th day, been very "nervy" all week. I am gonna hang in for a few days, I spoke to my pharmicist, I have a panic disorder, so I have alot of anxiety issues, usually kept at bay though, she said it could be causing me to feel this way. I really want to use this to help me with the smoking, but my body may not let me. Any of your thoughts or experiences would be appreciated, or anyone else that wants to share. Thanks!

hugs,
sisofD

[historyteach]

Yes, SisofD;
That's a definate side effect. It WILL pass.
Some people get anxiety from zyban. If that's the case, you may want to reconsider. But, I would suggest you use the extra energy in a positive way. Start an exercise routine, for example, and that in itself will help you stay committed to quitting!
I also have a panic disorder, so, it can be done.

Do your best. And do whatever it is that is right for you! You can quit either way. Sometime, just like meds, we have to try another way. Keep up the good work!

Shalom!

[sisterofD]

I hope it will pass, I dont like the nervy feel, I am feeling better this evening, thanks for your info and thanks for the encouragement!

hugs,
sisofD

[CAPTAINZING2000]

We have something like this in AA switching from scotch to brandy.


I think, the AMA are a bunch of pill pushers. I didn't get sober to switch to another bad habit. I quit smoking over a week ago w/o any bad urges.

With every fiber in my being I believe what it says in Ecclesiastes 3:1

It worked for me before. Quitting is the easy part in almost everything, changing your life style makes it hard!!! I no longer hang around smokers during breaks. I don't allow anyone to come inside my house and smoke.

Most of all coming on here and knowing if, you all are not smoking, I'll be damned if, I can't stop as well. LOL I'm a counting on you all to keep it up


thanks

[historyteach]

Capt;
With respect, I disagree.
The nicotine replacement therapy would be a more apt description of what you describe. Some would say that the patch or gum is equal to switching from scotch to brandy. But, I still wouldn't agree there either. NRT simply gives you the time to work on the underlying behaviors attached to smoking. And it's those behaviors which cause the relapses.
But, zyban is not a nicotine replacement at all. It was originally manufactured as an anti-depressant. One of it's attributes is that it did not cause the sexual side effects that other anti-d's cause. But, it was found that it helped people quit smoking by a significant percent. There is NO nicotine in zyban at all. The anology doesn't work. But, zyban helps us by helping us not obsess on the cravings. For many people, myself included, that's a huge problem.
I'm glad you didn't have those strong urges. Having once smoked over 3 packs a day, I can assure you, I did. And to quit smoking, I would say to do whatever it takes.
I bet you would say the same thing about quitting drinking too, wouldn't you?

Shalom!

[CAPTAINZING2000]

Teach,

I didn't
use any substitute after I stopped drinking.

I swear, they want to dole out pills for everything. Little overweight, take a pill, feeling a little blue take a pill. I don't buy this.

[historyteach]

To each his/her own.
I still say to do whatever it takes to quit.

I'm sincerely happy for you that you didn't have those strong cravings. Not everyone is as lucky as you. You don't have to do anything that isn't right for you.

However, I've also seen first hand that people at meetings tell others to stop taking their prescribed anti depressants. They didn't "buy it" either. But, the person relapses as a result of not taking their medication. This happened to my son. And he refused to take meds for years because of others telling him he wouldn't be "clean" if he took medications he clearly needs. He has a bipolar disorder. Frankly, I don't "buy" lay people giving medical advice. The consequences are far too severe. That advice given to my son could have cost him his life! And continuing to smoke will indeed cost me my life. I have the beginning of COPD. I don't want to die that way. I will do whatever it takes, including medication.

Having said all that, I agree that there are some doctors who want to push a pill for everything. That's where our own personal responsibility comes in. In the end, we are all responsible. If you don't need it, don't take it. If you do, don't let anyone tell you not to take a medication that helps millions overcome physical problems - be it a mental disorder, like my son has; or a physical addiction such as my addiction to smoking.

None of us are doctors. I will follow my doctor's advice and what is clearly working for me. And again, I believe everyone should do whatever it takes to quit smoking. It's our lives - no one elses.

Shalom!