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Effectiveness of Varenicline in Psychiatric Patients with Co-Morbid Polysubstance Dependence

Published online by Cambridge University Press:  09 May 2014

Jungjin Kim ,
Prashant Kaul ,
Thomas L. Schwartz  and
James Megna
Jungjin Kim
Affiliation:
State University of New York Upstate Medical University, Department of Psychiatry, Syracuse, New York
Prashant Kaul
Affiliation:
State University of New York Upstate Medical University, Department of Psychiatry, Syracuse, New York
Thomas L. Schwartz*
Affiliation:
State University of New York Upstate Medical University, Department of Psychiatry, Syracuse, New York
James Megna
Affiliation:
State University of New York Upstate Medical University, Department of Psychiatry, Syracuse, New York
*
Address for correspondence: Thomas Schwartz, Department of Psychiatry, SUNY Upstate Medical University, Syracuse NY 13210. Email: schwartt@upstate.edu
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Abstract

Introduction: Individuals with substance use disorders (SUDs) and mental health disorders (MHDs) have greater prevalence of smoking and suffer greater tobacco-related morbidity and mortality. Varenicline is the latest FDA-approved smoking-cessation agent and few studies have investigated the use of varenicline in this difficult-to-treat population.

Aims: This study examines the smoking cessation outcomes and tolerability of varenicline when used to help quit smoking in 16 patients enroled in both psychiatric and substance abuse programme.

Methods: A retrospective chart review was conducted on 16 patient charts. Patient demographics, psychiatric disorder diagnoses, substance use history, dosing, side effects, number of cigarettes used pre/post varenicline use and the number of complete smoking cessation outcomes were tabulated.

Results: After varenicline intervention, 25% of those who completed treatment completely quit smoking. Thirty-one per cent were able to substantially cut back the amount that they smoked to one cigarette per day. The average reduction in cigarettes was 16 per day (64%), and all but one patient tolerated varenicline.

Conclusions: The authors observed reasonable clinical benefit when varenicline was used to help quit smoking in patients with comorbid SUDs and MHDs. Better-controlled future studies with larger sample sizes will help further determine clinical utility of varenicline in this difficult-to-treat nicotine-dependent population.

Type
Original Articles
Information
Journal of Smoking Cessation , Volume 11 , Issue 1 , March 2016 , pp. 1 - 4
Copyright
Copyright © The Author(s), published by Cambridge University Press on behalf of Australian Academic Press Pty Ltd 2014 

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References

Baker, A., Richmond, R., Haile, M., Lewin, T. J., Carr, V. J., Taylor, R. L., et al. (2006). A randomized controlled trial of a smoking cessation intervention among people with a psychotic disorder. American Journal of Psychiatry, 163 (11), 1934–1942.Google Scholar
Bobo, J. K. (1989). Nicotine dependence and alcoholism epidemiology and treatment. Journal of Psychoactive Drugs, 21 (3), 323–329.CrossRefGoogle ScholarPubMed
Dani, J. A., & Harris, R. A. (2005). Nicotine addiction and comorbidity with alcohol abuse and mental illness. Nature Neuroscience, 8 (11), 1465–1470.Google Scholar
Diaz, F. J., Rendon, D. M., Velasquez, D. M., Susce, M. T., de Leon, J. (2006). Datapoints: Smoking and smoking cessation among persons with severe mental illnesses. Psychiatric Services, 57 (4), 462.Google Scholar
DiFranza, J. R., & Guerrera, M. P. (1990). Alcoholism and smoking. Journal of Studies on Alcohol and Drugs, 51 (2), 130–135.Google Scholar
Gonzales, D., Rennard, S. I., Nides, M., Oncken, C., Azoulay, S., Billing, C. B. et al. (2006). Varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs sustained-release bupropion and placebo for smoking cessation: a randomized controlled trial. JAMA: The Journal of the American Medical Association, 296 (1), 47–55.Google Scholar
Gunnell, D., Irvine, D., Wise, L., Davies, C., & Martin, R. M. (2009). Varenicline and suicidal behaviour: a cohort study based on data from the General Practice Research Database. British Medical Journal, 339:b3805.Google Scholar
Henningfield, J. E., Fant, R. V., Buchhalter, A. R., & Stitzer, M. L. (2005). Pharmacotherapy for nicotine dependence. CA: A Cancer Journal For Clinicians, 55 (5), 281–299.Google Scholar
Hughes, J. R., & Kalman, D. (2006). Do smokers with alcohol problems have more difficulty quitting? Drug and Alcohol Dependence, 82 (2), 91–102.Google Scholar
Jorenby, D. E., Hays, J. T., Rigotti, N. A., Azoulay, S., Watsky, E. J., Williams, K. E. et al. (2006). Efficacy of varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs placebo or sustained-release bupropion for smoking cessation: a randomized controlled trial. JAMA: The Journal of the American Medical Association, 296 (1), 56–63.Google Scholar
Lasser, K., Boyd, J. W., Woolhandler, S., Himmelstein, D. U., McCormick, D., & Bor, D. H. (2000). Smoking and mental illness: A population-based prevalence study. JAMA: The Journal of the American Medical Association, 284 (20), 2606–2610.Google Scholar
Lawrence, D. M., Holman, C. D., Jablensky, A.V., & Hobbs, M.S. (2003). Death rate from ischaemic heart disease in Western Australian psychiatric patients 1980–1998. British Journal of Psychiatry, 182:31–36.Google Scholar
Marks, J. L., Hill, E. M., Pomerleau, C. S., Mudd, S. A., & Blow, F.C. (1997). Nicotine dependence and withdrawal in alcoholic and nonalcoholic ever-smokers. Journal of Substance Abuse Treatment, 14 (6), 521–527.Google Scholar
Masuhara, J. E., Heath, T., & Okoli, C. (2013). Outcomes of a tobacco treatment programme for individuals with severe and persistent mental illness attending a community mental health team. Journal of Smoking Cessation, doi:10.1017/jsc.2013.17 Google Scholar
Oncken, C., Gonzales, D., Nides, M., Rennard, S., Watsky, E., Billing, C. B. et al. (2006). Efficacy and safety of the novel selective nicotinic acetylcholine receptor partial agonist, varenicline, for smoking cessation. Archives of Internal Medicine, 166 (15), 1571–1577.Google Scholar
Pfizer. (2012). Citing Websites. In CHANTIX® (varenicline) tablets. Retrieved 21 August 2013, from http://labeling.pfizer.com/ShowLabeling.aspx?id=557.Google Scholar
Pomerleau, C. S., Marks, J. L., Pomerleau, O.F. (2000). Who gets what symptom? Effects of psychiatric cofactors and nicotine dependence on patterns of smoking withdrawal symptomatology. Nicotine & Tobacco Research, 2 (3), 275–280.Google Scholar
Tonstad, S., Davies, S., Flammer, M., Russ, C., & Hughe, J. (2010). Psychiatric adverse events in randomized, double-blind, placebo-controlled clinical trials of varenicline: a pooled analysis. Drug Safety, 33 (4), 289–301.Google Scholar
Vaillant, G. E., Schnurr, P. P., Baron, J. A., & Gerber, P. D. (1991). A prospective study of the effects of cigarette smoking and alcohol abuse on mortality. Journal of General Internal Medicine, 6 (4), 299–304.Google Scholar
Xian, H., Scherrer, J. F., Madden, P. A., Lyons, M. J., Tsuang, M., True, W. R. et al. (2005). Latent class typology of nicotine withdrawal: genetic contributions and association with failed smoking cessation and psychiatric disorders. Psychological Medicine, 35 (3), 409–419.CrossRefGoogle ScholarPubMed