Doctors prescribe Zyban to people who are having trouble quitting smoking. Apparently, it helps reduce the cravings, irratibility, and sluggishness that often afflict people trying to quit. Intriguingly, Zyban is chemically identical to Wellbutrin, a common antidepressant drug; they're both bupropion hydrochloride. Buproprion is actually an atypical antidepressant; instead of acting on serotonin and norepinephrine, it blocks the reuptake of dopamine.

Why market the same drug under two different names? Pure psychology, I think. If you asked your doctor to help you stop smoking, and he prescribed you an antidepressant, you might think he was implying that you were mentally ill. Given the stigma associated with psychiatric illness and psychiatric medicine, you might be less likely to take the drug. You might even say, "Geez, what the hell is this quack doing? I'm not depressed; I'm trying to stop smoking!" This way, if you check up on your doctor, you'll see he's prescribed you an antismoking drug, and all will be well.

Now, I'm not saying that you shouldn't take Zyban--it seems to work, which is what's important. I'm just saying that the placebo effect rocks.


Interesting point by whizkid...I hadn't thought of that possibility but it seems quite plausible (heck, my own insurance company covers antidepressants but not antismoking drugs). One problem, though: Wellbutrin (the antidepressant that most health insurance plans cover) was introduced before Zyban (the antismoking drug that most plans won't cover). Why then create Zyban at all, given that it would be less lucrative? (I'm not aware of any insurance programs that cover smoking-cessation drugs but not antidepressants). I suppose it's possible that some insurance companies might get upset that you're using a drug for something other than its express purpose, but off-label prescriptions are relatively common and it's possible to get an existing drug approved for a second purpose.