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Excerpts from Now that is a wonder drug

Electronic Telegraph [06/29/99]

Can one pill ease depression, help you lose weight and give up smoking? Celia Hall reports

A PILL that makes it easier to lose weight, reduces cravings for cigarettes and treats depression sounds too good to be true. Yet, astonishingly, research is accumulating which shows that an anti-depressant might be able to do just that.

The circumstances in which the pill's three effects were discovered are familiar. As with Viagra - developed to treat a heart condition and now prescribed for impotence - a medicine designed to treat one ailment has been found to have an unexpectedly useful side effect, perhaps two.

In this case, the drug is bupropion hydrochloride, which was first licensed in America in 1996 to treat depression, under the trade name Wellbutrin. Its particular claim to fame is that it does not interfere with sexual function, a side effect of some other antidepressants.

During trials, it became clear, by chance, that people taking the tablets found it easier to stop smoking. They said that the craving for cigarettes was easier to cope with.

The manufacturer, Glaxo Wellcome, quickly set up more trials specific to giving up smoking. In the study, 893 smokers with a habit of at least 15 cigarettes a day took one of four options: bupropion, a placebo, a nicotine patch or a nicotine patch together with the active drug.

Bupropion doubled people's chances of stopping smoking. After a year, 35.5 per cent of those on the drug and the patch had stopped; 30.3 per cent of those on the drug alone; 16.4 per cent of those using the patch alone and 15.6 per cent of those taking the dummy pill.

In 1997, bupropion - now also called Zyban - was given a licence for use in America as an aid to giving up smoking; Canada quickly followed suit. Applications have been made for a European licence, and Holland, as the test country, is expected to grant a licence within months.

At this point, an American psychiatrist enters the picture. Dr Kishore Gadde, director of the multi-centre clinical trials in psychiatry, Duke University, Durham, North Carolina, was treating a group of obese women and had put some of them on Wellbutrin, to help them with mild depression. These women lost more weight than those not taking the drug, so Dr Gadde set up a double blind trial - in which neither the women nor Dr Gadde knew who was taking what; 25 women took the drug and 25 did not.

"They were all on 1,600 calories a day and their average weight was 220lb (15 stone 10lb). After eight weeks, women taking the drug had lost an average of 14lb compared with 3.5lb for the women taking the placebo," he says. "This is not a flash in the pan. They have continued with their weight loss over a year. There do not appear to be withdrawal symptoms when they stop taking the drug.

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