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This combination therapy approach was evaluated in a Phase 4 clinical trial (NIDA 5R01DA011512) for the treatment of tobacco use disorder in individuals with unipolar depression. The regimen consists of **bupropion sustained-release (SR)**, a small molecule antidepressant that acts as a norepinephrine-dopamine reuptake inhibitor (NDRI) and a non-competitive antagonist at nicotinic acetylcholine receptors; **transdermal nicotine replacement therapy (nicotine patch)**, which provides a steady delivery of nicotine to stimulate nicotinic receptors and mitigate withdrawal; and **cognitive behavioral therapy (CBT)**, a behavioral intervention designed to address the psychological components of addiction and manage abstinence-associated depressive symptoms. The study aimed to determine if the addition of bupropion to standard nicotine replacement and behavioral support would improve long-term abstinence rates in smokers with a history of or current unipolar depressive disorder.
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