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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: Dr Schroeder¹ discusses bupropion as an aid to smoking cessation, since it decreases the craving for cigarettes and the symptoms of withdrawal. Noting the high prevalence of psychiatric disorders among smokers, he comments that bupropion "has the added advantage of treating both conditions [craving/withdrawal and depression] simultaneously."

Nicotine itself may be thought of as a rapidly acting antidepressant, since it leads to improvement of mood and cognition, and is also anxiolytic. Nicotine may act as an antidepressant because of augmentation of the release of neurotransmitters putatively involved in depression.² Bupropion may actually be acting as a nicotine substitute.

Unfortunately, bupropion may not be as easy to use as Schroeder states. Bupropion may affect the cytochrome P450 (CYP) enzymes and is as potent a CYP2D6 inhibitor as fluoxetine.³ For example, a case report described a patient for whom bupropion was added to a medication regimen that included metoprolol . . . [Full Text of this Article]

Frances R. Frankenburg, MD
Frances.Frankenburg@med.va.gov
Department of Psychiatry
Boston University School of Medicine
Bedford, Mass

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