Anti-smoking drugs seem to be effective

Anti-smoking drugs effectively reduce the craving for smoking: US researchers confirm the effects of bupropion and varenicline

01/05/2011

„Finally, stop smoking!“ - so also in this year the good intention of numerous German citizens. But like every year in 2011, many will not be able to resist the grip of the cigarette. The reason: key stimuli that trigger a strong desire for the usual smoldering stems. Here anti-smoking medicines can apparently remedy, as US researchers in the latest issue of the journal „Archives of General Psychiatry“ to report.

Looking at a cigarette, the company of other smokers, the habit of eating or other specific feelings and situations are key stimuli that can trigger the so-called craving - the strong desire for a cigarette. US researchers have now visualized this need with the help of magnetic resonance imaging, studying the effect of anti-smoking drugs on brain activity.

Christopher Culbertson from the University of California has presented short video clips to 30 smokers as part of his study, giving them key stimuli. At the same time, Culbertson investigated the brain activity of smokers using functional magnetic resonance imaging (MRI). After setting the key stimuli, significantly increased activity became visible in several brain regions of the study participants. Both the prefrontal cortex (attention), the amygdala (emotion) and the tegmentalis ventralis (reward system) as well as the striatum (motivation) had an increased brain activity, said Christopher Culbertson and colleagues.

Antidepressant Bupropion apparently also helps with nicotine addiction
To evaluate the effect of the anti-smoking drug bupropion, Christopher Culbertson performed the MRI scan before and after the end of an eight-week treatment with bupropion (15 participants) or a placebo (15 participants). The MRI images have shown that the drug actually inhibits the onset of cravings in various parts of the brain, the US researchers reported in its current release. This diminished activity in the different brain regions was also consistent with the decreased desire that the subjects indicated in questionnaires to be completed in addition, Culbertson continued.

Originally developed as an antidepressant, bupropion has long been considered an effective aid on the way to becoming a nonsmoker. His effect was discovered more by accident than patients who took bupropion were more likely to get rid of the cigarette. Why that is so, now clarify their investigations, said Christopher Culbertson. Apparently bupropion inhibits the activity in the crucial brain regions, so that the smoker feel with corresponding key stimuli a less pronounced desire for a cigarette, so the statement of the expert.

Even the anti-smoking drug Varenicline shows effect
In a further study, the team of researchers led by Teresa Franklin from the University of Pennsylvania in Philadelphia, the drug already approved as anti-smoking drug varenicline. The methodology also in the specialist magazine „Archives of General Psychiatry“ Published study closely resembles the studies presented above by Christopher Culbertson. Teresa Franklin and colleagues also showed 22 smokers about 10 minutes of video sequences with key stimuli (eg, smoking people) before and after a three-week addiction with varenicline or placebo while the study participants were on an MRI. Again, prior to therapy, the part of the brain associated with addiction has shown significantly increased activity, as Teresa Franklin reports. After the three-week treatment with the anti-smoking drug, the activity in the corresponding brain regions had been much lower, the expert continued. Varenicline, according to the manufacturer, alleviates withdrawal symptoms and minimizes the effect of smoking by inhibiting the nicotine kick. The reduced craving seen in the diminished activation of the various brain centers and also observed by the smokers themselves in the studies of Teresa Franklin seems clearly confirm the statements of the manufacturers.

Criticizing the fight against tobacco addiction with drugs
However, critics see the increased use of nicotine addiction medication as an escape route rather than a solution to the problem. For instead of taking on responsibility and fundamentally changing their behavior, smokers would substitute their cigarette addiction only with other drugs. Although this could significantly reduce the health risk, the fundamental causes of the addictive behavior would not be eliminated. Here the personal responsibility of the patients may be required with psychotherapeutic support, instead of providing the smokers with pills, so the charge on the part of many critical doctors. (Fp)

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