Neuropsychiatric safety and efficacy of varenicline, bupropion, and nicotine patch in smokers with and without…

Worth asking your prescriber what mood or behavior changes to watch for when starting bupropion for smoking cessation, especially if you have an existing psychiatric condition.

moderate evidence63/100

Reasonable evidence with real limitations. how we score evidence

Caveat on this rating: Funded by Pfizer and GlaxoSmithKline, the manufacturers of the drugs studied; several authors were Pfizer or GSK employees.

FDA approvedbupropion (Wellbutrin, Zyban, Aplenzin, Forfivo)wellbutrinzybanaplenzinforfivo

In an 8,144-smoker randomized trial, bupropion did not significantly increase moderate-to-severe neuropsychiatric adverse events versus placebo (risk difference -0.08 percentage points, 95% CI -1.37 to 1.21), including in the half of participants with psychiatric disorders.

Worth asking

Worth asking your prescriber what mood or behavior changes to watch for when starting bupropion for smoking cessation, especially if you have an existing psychiatric condition.

What it is FDA approved for

Read off the label. Trial duration and approval year are shown only where they were recorded — never inferred.

  • Major depressive disorder
  • Prevention of seasonal major depressive episodes (seasonal affective disorder)
  • Aid to smoking cessation

Source

Neuropsychiatric safety and efficacy of varenicline, bupropion, and nicotine patch in smokers with and without psychiatric disorders (EAGLES): a double-blind, randomised, placebo-controlled clinical trial — Anthenelli RM, et al. (2016)

Top-tier peer-reviewed journal

Read the source: https://doi.org/10.1016/S0140-6736(16)30272-0

DOI: 10.1016/S0140-6736(16)30272-0

How this was scored

Study design
Randomised controlled trial
Funding
Industry funded
Published in
Top-tier peer-reviewed journal
Sample size
8,144
Preregistered
Yes
Conflicts disclosed
Yes
Independent of proponent
No
Retracted
No

Read the full scoring rubric, including what it can't tell you.

Published August 19, 2026.

Questions

How strong is the evidence behind this?

Resolv rates this source "moderate evidence". Reasonable evidence with real limitations. It scores 63 out of 100 on our published rubric. One caveat travels with that badge: Funded by Pfizer and GlaxoSmithKline, the manufacturers of the drugs studied; several authors were Pfizer or GSK employees. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.

What is the source for this?

Neuropsychiatric safety and efficacy of varenicline, bupropion, and nicotine patch in smokers with and without psychiatric disorders (EAGLES): a double-blind, randomised, placebo-controlled clinical trial — Anthenelli RM, et al. (2016). Published in: Top-tier peer-reviewed journal. DOI: 10.1016/S0140-6736(16)30272-0. The full source is linked on this page so you can read it yourself.

Who paid for this research, and does that matter?

Study design: Randomised controlled trial. Funding: Industry funded. The researchers were not independent of whoever benefits from the result. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.

Is bupropion (Wellbutrin, Zyban, Aplenzin, Forfivo), wellbutrin, zyban, aplenzin, forfivo FDA approved?

Yes — FDA approved for Major depressive disorder, Prevention of seasonal major depressive episodes (seasonal affective disorder), Aid to smoking cessation. Approval is for a specific indication, not for everything the drug is prescribed for.

Is this medical advice?

This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.

This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.