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Bupropion increases smoking abstinence rates in smokers with schizophrenia, without jeopardizing their mental state. Varenicline may also improve smoking cessation rates in schizophrenia, but its possible psychiatric adverse effects cannot be ruled out. There are insufficient studies of NRT or behavioural interventions in this population to be able to make a recommendation.



A review of interventions for smoking cessation and reduction for patients with schizophrenia found a benefit of bupropion in both the short- and the long-term. There were no significant differences in positive, negative and depressive symptoms between bupropion and placebo groups, and there were no reports of major adverse events, such as seizures. Varenicline may also improve smoking cessation rates in schizophrenia, but its possible psychiatric adverse effects cannot be ruled out. There was too little evidence to be able to discern if other interventions, including behavioural interventions and NRT, are effective in this population.



Tsoi DT, Porwal M, Webster AC. Interventions for smoking cessation and reduction in individuals with schizophrenia. Cochrane Database of Systematic Reviews 2013, Issue 2. Art. No.: CD007253. DOI: 10.1002/14651858.CD007253.pub3.

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