Prescription Medications for Smoking Cessation
FDA-approved medications that can significantly increase your chances of quitting smoking successfully.
How Prescription Medications Help You Quit
Prescription medications for smoking cessation work differently than nicotine replacement therapies. Instead of providing nicotine in a safer form, these medications target the brain's nicotine receptors or affect brain chemicals to reduce cravings and withdrawal symptoms.
Clinical studies show that prescription medications can double or even triple your chances of quitting successfully compared to placebo.
These medications require a prescription from a healthcare provider, who will evaluate your medical history to determine if they're appropriate for you. They're typically used as part of a comprehensive quit plan that includes counseling or behavioral support.
Types of Prescription Medications
Nicotine Receptor Partial Agonists
Medications like varenicline (Chantix) that bind to nicotine receptors in the brain, partially stimulating them to reduce withdrawal symptoms while also blocking the pleasurable effects of nicotine if you do smoke.
Antidepressants
Certain antidepressants like bupropion (Zyban, Wellbutrin) can help reduce nicotine cravings and withdrawal symptoms by affecting neurotransmitters in the brain.
FDA-Approved Prescription Medications
Chantix (Varenicline)
Chantix (varenicline) works by targeting nicotine receptors in the brain, reducing the pleasure from smoking and decreasing withdrawal symptoms.
Key Features
- Blocks the pleasurable effects of nicotine in the brain
- Reduces cravings and withdrawal symptoms
- Does not contain nicotine
- Typically prescribed for a 12-week treatment course
- Can be used with a gradual approach to quitting
Pros
- One of the most effective smoking cessation medications
- Can be used while still smoking during the first week
- Doesn't contain nicotine
- May reduce the enjoyment of smoking, making it easier to quit
Cons
- Requires a prescription
- More expensive than over-the-counter options
- May cause vivid dreams, nausea, and other side effects
- Not suitable for everyone due to potential psychiatric side effects
Zyban (Bupropion)
Zyban (bupropion) is an antidepressant that reduces cravings and other withdrawal symptoms. It doesn't contain nicotine.
Key Features
- Acts on chemicals in the brain related to nicotine cravings
- Reduces withdrawal symptoms and the urge to smoke
- Does not contain nicotine
- Treatment typically begins 1-2 weeks before your quit date
- Usually prescribed for 7-12 weeks
Pros
- Can help manage weight gain often associated with quitting
- May help with depression symptoms during quitting
- Doesn't contain nicotine
- Can be combined with NRT for better results
Cons
- Requires a prescription
- Not suitable for people with certain medical conditions
- May cause insomnia, dry mouth, and other side effects
- Small risk of seizures and psychiatric side effects
Wellbutrin (Bupropion)
Wellbutrin is the brand name for bupropion when prescribed for depression, but it's the same medication as Zyban and works the same way for smoking cessation.
Key Features
- Same active ingredient as Zyban (bupropion)
- Reduces nicotine cravings and withdrawal symptoms
- Also treats depression and seasonal affective disorder
- Treatment begins 1-2 weeks before quit date
- Usually prescribed for 7-12 weeks for smoking cessation
Pros
- May help with depression symptoms during quitting
- Can help manage weight gain often associated with quitting
- Doesn't contain nicotine
- Can be combined with NRT for better results
Cons
- Requires a prescription
- Not suitable for people with certain medical conditions
- May cause insomnia, dry mouth, and other side effects
- Small risk of seizures and psychiatric side effects
Important Safety Information
All prescription medications for smoking cessation carry potential risks and side effects. Always consult with a healthcare provider before starting any medication and report any unusual symptoms immediately.
Common Side Effects
Varenicline (Chantix)
- Nausea and vomiting
- Sleep disturbances and vivid dreams
- Headache
- Constipation or gas
- Changes in taste perception
Bupropion (Zyban, Wellbutrin)
- Dry mouth
- Insomnia
- Headache
- Agitation or anxiety
- Constipation
Serious Warnings
Both varenicline and bupropion carry FDA warnings about the risk of serious mental health side effects, including:
- Changes in behavior
- Hostility or agitation
- Depressed mood
- Suicidal thoughts or actions
These risks are higher for people with a history of psychiatric disorders. Your healthcare provider will weigh the benefits against the risks based on your medical history.
Frequently Asked Questions
How do I get a prescription for smoking cessation medication?
You'll need to schedule an appointment with your primary care physician or another healthcare provider. During the appointment, discuss your smoking history, previous quit attempts, and any medical conditions or medications you're currently taking. Your provider will determine if prescription medication is appropriate for you and which one might be the best fit.
Can I use prescription medications with nicotine replacement therapy?
Bupropion (Zyban, Wellbutrin) can be safely used with nicotine replacement therapy, and this combination may be more effective than either treatment alone. Varenicline (Chantix) is typically not used with NRT, although some studies have explored this combination. Always consult with your healthcare provider before combining any smoking cessation treatments.
How long will I need to take the medication?
Standard treatment duration is typically 12 weeks for both varenicline and bupropion. However, your healthcare provider may recommend a longer course of treatment if needed, especially if you've recently quit and are concerned about relapse. Some people benefit from up to 6 months of treatment.
Are these medications covered by insurance?
Many insurance plans, including Medicare and plans under the Affordable Care Act, cover prescription smoking cessation medications. Coverage details vary by plan, so check with your insurance provider. Some plans may require prior authorization or limit how many quit attempts they'll cover per year.
What if I relapse while taking medication?
If you slip and smoke while on medication, don't stop taking it. Continue with your treatment and recommit to your quit plan. Talk to your healthcare provider about the relapse and whether any adjustments to your treatment plan might be helpful. Remember that many successful quitters make multiple attempts before quitting for good.
Ready to Discuss Medication Options?
Talk to a healthcare provider about which prescription medication might be right for your quit journey.