Medications Thwart Smokers' Cravings

Varenicline and bupropion appear to blunt cue-induced desire

THURSDAY, Jan. 6 (HealthDay News) -- Varenicline and bupropion appear to influence brain pathways associated with cue-induced cravings in smokers, according to two articles published online Jan. 6 in the Archives of General Psychiatry.

Teresa Franklin, Ph.D., of the University of Pennsylvania in Philadelphia, and colleagues randomized 22 nicotine-dependent volunteers to varenicline or placebo to test the hypothesis that the medication would blunt reward-related responses to smoking cues in the ventral striatum and medial orbitofrontal cortex and help reduce cue-elicited cravings. They found that the drug's reciprocal actions in the reward-evaluating lateral orbitofrontal cortex and the reward-activated medial orbitofrontal cortex underlie a lessened smoking cue response, which probably contributes to the drug's clinical efficacy.

Christopher S. Culbertson, Ph.D., of the University of California in Los Angeles, and colleagues randomly assigned 39 nicotine-dependent volunteers to eight weeks of bupropion or placebo. The treatment group reported reduced cue-induced craving and showed a reduction in cue-induced activity in the limbic and prefrontal brain regions.

"In summary, a standard course of treatment with bupropion enhances the ability of smokers to resist cue-induced craving, measured as reductions in self-reported craving and reduced activation in the ventral striatum, anterior cingulate, and medial orbitofrontal cortex," Culbertson and colleagues conclude.

Several authors of the first study disclosed financial arrangements with pharmaceutical companies, including Pfizer, which provided funding for the study.

Abstract - Franklin
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Abstract - Culbertson
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