Are you worried you will choose the wrong medication? How do you determine what is the best option for you?
There are two medication options that do not include Nicotine; these are Varenicline (Chantix) and Bupropion (Zyban or Wellbutrin).
Varenicline:
- Varenicline (Chantix) was designed specifically to interact with the nicotine receptor in the brain. It was patterned after an old medication called cytosine. Cytosine was thought to block the nicotine receptor but cytosine did not have great results for smoking cessation.
- Head-to-head tests of both Varenicline and Bupropion show that Varenicline results in higher smoking cessation rates.
- The most common side effect due to Varenicline is mild nausea and for bupropion it is sleep disturbance.
Bupropion:
- Bupropion (Zyban or Wellbutrin) was initially developed and currently used as an antidepressant, and through the almost accidental observations of a psychiatrist at a California VA hospital, was found to reduce smoking in people who were taking it for depression.
- Bupropion may reduce the weight gain often experienced by people after they quit smoking; and it may reduce the negative moods often experienced after smoking cessation. Varenicline does not appear to have these positive effects.
- Bupropion may interact with other drugs that may require adjusting the dose of these medications. Varenicline has no important interactions with other drugs.
Both Varenicline and Bupropion:
- One study showed that combining the two drugs resulted in higher smoking cessation rates for heavier smokers (over 20 cigarettes per day) when compared to taking Varenicline alone.
- Either drug can be combined with Nicotine Replacement Therapies (NRT); this may boost the smoking cessation rates when compared with Varenicline or bupropion alone.
Choosing which medication may be right for any given person requires weighing the potential benefits and differences in the medication to find the best fit for a particular person. Your doctor should be able to help with this decision. All things being equal, Varenicline may be the best choice for many smokers since it is associated with the best smoking cessation rates.
