Skip to content

Bupropion

What it is

A prescription medication (bupropion SR; also marketed as an antidepressant under other brand names) used for smoking cessation. It is not nicotine-based.

How it works

Its exact mechanism in cessation is not fully understood. It affects dopamine and noradrenaline pathways implicated in reward and withdrawal, and appears to reduce craving and withdrawal symptoms.

What the evidence shows

  • The Cochrane review of antidepressants for smoking cessation found bupropion approximately doubles quit rates versus placebo — see R-003.
  • In EAGLES, bupropion showed no significant increase in moderate-to-severe neuropsychiatric adverse events versus placebo — see R-015.
  • WHO (2024), USPSTF (2021) and NICE (NG209) all include bupropion among recommended options; it is often the choice when varenicline is unavailable or unsuitable.

Common considerations

  • Insomnia and dry mouth are commonly reported.
  • Bupropion lowers seizure threshold; it is not used in people with seizure disorders, eating disorders with purging, or certain other conditions — suitability is a clinical decision.
  • It can be combined with NRT in some protocols; ask about combined treatment.

Questions to ask a healthcare professional

  • Do any of my conditions or medications interact with bupropion?
  • What should I do if sleep becomes difficult after starting?
  • Is combining bupropion with NRT appropriate for me?

Related: Varenicline · NRT · Research record R-003