Bupropion is an atypical antidepressant that acts as a norepinephine and dopamine reuptake inhibitor, and nicotinic antagonist ,Initially researched and marketed as an antidepressant, bupropion was subsequently found to be effective as a smoking cessation aid.

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Bupropion reduces the severity of nicotine cravings and withdrawal symptoms. After a seven-week treatment, 27% of subjects who received bupropion reported that an urge to smoke was a problem, versus 56% of those who received placebo. In the same study, 21% of the bupropion group reported mood swings, versus 32% of the placebo group. The bupropion treatment course lasts for seven to twelve weeks, with the patient halting the use of tobacco about ten days into the course. The efficacy of bupropion is similar to that of nicotine replacement therapy. Bupropion approximately doubles the chance of quitting smoking successfully after three months. One year after the treatment, the odds of sustaining smoking cessation are still 1.5 times higher in the bupropion group than in the placebo group. The combination of bupropion and nicotine appears not to further increase the cessation rate. In a direct comparison, varenicline (Chantix) showed superior efficacy: after one year, the rate of continuous abstinence was 10% for placebo, 15% for bupropion, and 23% for varenicline. Bupropion slows the weight gain that often occurs in the first weeks after quitting smoking (after seven weeks, the placebo group had an average 2.7 kg increase in weight, versus 1.5 kg for the bupropion group). With time, however, this effect becomes negligible (after 26 weeks, both groups recorded an average 4.8 kg weight gain).

Activity of Bupropionins
Bupropionis may further improve smoking cessation succesfully rate, Nicotine facilitates norpnephron and dopamine release in the central nervous system bupropion mares nicotine by inhibiting norodrenaline and dopamine reuptake a process that some researchers believe alters nicotine withdrawal symptoms. Pulmonary rehabilitation involves education and exercise aimed at improving patient’s quality of life eliminating COPD burden

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