Which medication is a non-nicotine pharmacotherapy for nicotine dependence that increases dopamine and norepinephrine?

• A. Varenicline
• B. Naltrexone
• C. Bupropion
• D. Baclofen

Answer: (C)

The main concept here is using a non-nicotine medication that boosts dopamine and norepinephrine to ease nicotine withdrawal and cravings. Bupropion does this by inhibiting the reuptake of dopamine and norepinephrine, increasing their levels in the brain. That enhanced dopaminergic and noradrenergic activity helps lessen withdrawal symptoms and the urge to smoke, making cessation more achievable without using nicotine itself. It’s different from other options that affect nicotine dependence through receptor-level or opioid pathways rather than by raising these monoamines. For example, some medications modulate nicotinic receptor activity to blunt cravings, or block opioid receptors to reduce nicotine’s rewarding effects, or act on GABA systems, rather than primarily increasing dopamine and norepinephrine. Bupropion is also used as an antidepressant, which can be beneficial for mood during quitting. Remember to consider contraindications like seizure disorders or certain eating disorders and monitor dosing to minimize risks.