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Smoking and Tobacco

Cravings with the patch and Wellbutrin

06/02/1998

Question:

I have been taking 300mg. of Wellbutrin for a week. I have been using the 21mg. patch for three days. I still have intense cigarette cravings. How long should they last? After I stop the 7mg. patch will these cravings continue? How long should I continue to take Wellbutrin after I stop using the patch?

Answer:

Generally, Wellbutrin (bupropion) can be used alone for smoking cessation. It commonly is prescribed for 7 to 12 weeks with quit rates of 33% at 52 weeks of smoking cessation. When used with patches, it should be taken for at least the length of time that the patch is being used, which generally is between one and three months. The quit rate at 52 weeks when used with the patch is 38%. These quit rates are from one study only and other studies have shown similar but slightly lower quit rates.

If you are still having intense cravings, it may be because you were smoking more than two packs per day. If this is not the case, it may just be that bupropion will not be effective for you, since the quit rate is not 100%, even with addition of the patch to bupropion.

You may wish to discuss your cravings further with your physician. There may be some underlying reasons for your smoking such as anxiety, depression or obsessive/compulsive disorder. These conditions can be successfully treated with medications and/or behavior modification and it may be that once these conditions are under control, that smoking cessation should be easier to accomplish.

Don't give up!

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Response by:

Margaret C Sweeney, MD
Formerly, Associate Professor of Clinical Family Medicine
College of Medicine
University of Cincinnati