Opinion Skinning Left, pagematch: 1, sectionmatch: 1
Opinion ( Leaderboard Top ), pagematch: 1, sectionmatch: 1

Varenicline helps smokers with stable depression

Varenicline successfully promoted durable smoking cessation without exacerbating depression or anxiety in a randomized, phase IV, industry -funded study of patients with stably treated major depressive disorder.

Smoking cessation, defined as carbon monoxide-confirmed continuous abstinence, was higher at week 9 to 12 among 256 subjects in the double-blind study who where randomized to receive varenicline, compared with 269 who received placebo, reported by the University of California, San Diego.

The differences between the groups were significant for weeks 9 to 24 and for weeks 9 to 52, the researchers said.

No clinically relevant differences were seen between the groups in suicidal ideation or behavior as captured by the Columbia Suicide Severity Rating Scale. No overall worsening of depression or anxiety occurred in either group. Trajectories of mood and anxiety rating trended slightly toward improvement in both groups.

The multicenter study comprised adults aged 19 to 73 years with no recent cardiovascular events, who smoked at least 10 cigarettes daily and had current or past stably treated unipolar major depressive disorder without psychotic features. They were recruited from 38 centers in eight countries between March 2010 and June 2012.

Randomization was stratified by antidepressant use at baseline (any vs. none) and by baseline depression core (Montgomery-Asberg Depression Raring Scale score 11 or less vs. greater than 11). Patients received placebo or varenicline titrated to a dose of 1 mg  twice daily for 12 weeks, with a 40-week nontreatment follow-up phase.

Opinion ( Article MRec ), pagematch: 1, sectionmatch: 1

Although 72.3% and 66.9% of the treatment and placebo groups, respectively, experienced treatment emergent adverse events, most were or moderate. The most frequent adverse events in the treatment vs. placebo groups were nausea” (27.0%vs. 10.4% respectively), headaches (16.8%vs. 11.2%) abnormal dreams (1l.3%vs. 8.2%), irritability (10.9% vs. 8.2%), and insomnia (10.9% vs. 4.8). Two patients in the treatment group died during the non-treatment phase, but neither  death was considered to be related to treatment, the researcher said.

Varenicline, like other Food and Drug Administration-approved smoking cessation aids for non -psychiatrically ill smoker, us similarly effective in smokers with a history of depression without increasing depressive symptoms; in the case of varenicline, as shown in this study, this applies to patients with depression who are using antidepressant medication.

“Varenicline is a partial agonist of brain alpha4beta2 nicotinic acetylcholine receptors and is believed to alleviate nicotine withdrawal while simultaneously blocking its rewarding effects. Because depressed smokers are prone to more severe nicotine withdrawal than nonpsychiatric smokers, mitigating withdrawal symptoms may be important in this population,” the researcher wrote. Depressed smokers who lapse into smoking while attempting to regulate mood may find cigarettes less reinforcing while taking varenicline, thus facilitating prolonged abstinence.

The findings may not extrapolate to untreated or actively depressed smokers and those with other psychiatric conditions, since only stably treated patients without psychotic features and other disorders associated with major depressive disorder were included, but there may be an important role for varenicline in smokers with a history of stably treated depression.

Opinion ( Article MRec ), pagematch: 1, sectionmatch: 1
  • Follow Us:
Opinion Skinning Right, pagematch: 1, sectionmatch: 1