Improved Depressive Symptoms in Adults with Schizophrenia During a Smoking Cessation Attempt with Varenicline and Behavioral Therapy

Cather, Corinne; Hoeppner, Susanne S.; Pachas, Gladys; Pratt, Sarah; Achtyes, Eric D.; Cieslak, Kristina; Evins, A. Eden

doi:10.1080/15504263.2017.1319585

Cited by 16 publications

(6 citation statements)

References 55 publications

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“…Moreover, there is evidence that quitting smoking is associated with recovery in stress, anxiety and depression in smokers. 44 54 55 A significant and progressive improvement of anxiety and depression was also reported in an observational study, and the protective effect was observed regardless of the presence of psychiatric pathology. 49 Many studies demonstrated gender differences in varenicline efficacy for smoking cessation 56 57 ; some studies also found a difference in neuropsychiatric events between genders.…”

Section: Main Findings and Interpretationmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

“…Of note, our result is consistent with another cohort study based on data from the general practice that a declined depression were observed to be associated with varenicline (HR 0.88, 95% CI 0.77 to 1.00) 30 ; similar finding was also reported in a clinical trial. 44 Patients with COPD are considered a high-risk population with high prevalence of smoking and relatively older age, making these persons more susceptible for possible ADEs. 17 45 Of note, in our study, we did not observe an increased risk of overall NPAEs among patients with COPD using varenicline in both the psychiatric and nonpsychiatric cohorts.…”

Section: Main Findings and Interpretationmentioning

confidence: 99%

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Neuropsychiatric safety of varenicline in the general and COPD population with and without psychiatric disorders: a retrospective cohort study in a real-world setting

et al. 2021

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ObjectivesTo evaluate the real-world association between varenicline and neuropsychiatric adverse events (NPAEs) in general and chronic obstructive pulmonary disease (COPD) population with and without psychiatric disorders compared with nicotine replacement therapy (NRT) to strengthen the knowledge of varenicline safety.DesignA retrospective cohort study.SettingPrescription database IADB.nl, the Netherlands.ParticipantsNew users of varenicline or NRT among general (≥18 years) and COPD (≥40 years) population. Psychiatric subcohort was defined as people prescribed psychotropic medications (≥2) within 6 months before the index date.Outcome measuresThe incidence of NPAEs including depression, anxiety and insomnia, defined by new or naive prescriptions of related medications in IADB.nl within 24 weeks after the first treatment initiation of varenicline or NRT.ResultsFor the general population in non-psychiatric cohort, the incidence of total NPAEs in varenicline (4480) and NRT (1970) groups was 10.5% and 12.6%, respectively (adjusted OR (aOR) 0.85, 95% CI 0.72 to 1.00). For the general population in psychiatric cohort, the incidence of total NPAEs was much higher, 75.3% and 78.5% for varenicline (1427) and NRT (1200) groups, respectively (aOR 0.82, 95% CI 0.68 to 0.99). For the COPD population (1598), there were no differences in the incidence of NPAEs between comparison groups in both the psychiatric cohort (aOR 0.97, 95% CI 0.66 to 1.44) and non-psychiatric cohort (aOR 0.81, 95% CI 0.54 to 1.20). Results from subgroup or sensitivity analyses also did not reveal increased risks of NPAEs but showed decreased risk of some subgroup NPAEs associated with varenicline.ConclusionsIn contrast to the concerns of a possible increased risk of NPAEs among varenicline users, we found a relative decreased risk of total NPAEs in varenicline users of the general population in psychiatric or non-psychiatric cohorts compared with NRT and no difference for NPAEs between varenicline and NRT users in smaller population with COPD.

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Section: Main Findings and Interpretationmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Main Findings and Interpretationmentioning

confidence: 99%

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Neuropsychiatric safety of varenicline in the general and COPD population with and without psychiatric disorders: a retrospective cohort study in a real-world setting

et al. 2021

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“…Un estudio norteamericano con 14 pacientes psiquiátricos internados mostró que no hubo alteración en la incidencia de contención física o mecánica después de la implementación de la prohibición de fumar (27) .…”

Section: Discussionunclassified

“…Algunos estudios identificaron beneficios para los pacientes psiquiátricos con el tratamiento de la dependencia del tabaco como: mejoría de la salud mental; reducción de los síntomas depresivos, y disminución de la dosimetría de antipsicóticos y antiparkinsonianos (27) .…”

Section: Discussionunclassified

Opinion and perception of attitudes related to smoking and its prohibition in mental health services

2022

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Introduction: The opinions and perceptions about smoking in the psychiatric population contribute to the fact that its prevalence in this population remains two or three times higher than that found in other groups.Aims: 1) To compare the opinions of the psychiatric population and general population regarding the smoking ban in mental health services, as well as their perception of mental health professionals’ attitudes in relation to smoking; 2) To identify the association between personal and clinical variables with opinions and perception of attitudes.Methods: This Brazilian cross-sectional epidemiological study took place in: Mental Health Outpatient Unit (n=126), Psychiatric Hospital (n=126) and Primary Health Unit (n=126). Individual interviews were performed using a questionnaire.Results: Most participants believe that smoking ban may aggravate psychiatric symptoms. When comparing the responses of the psychiatric population with those of the general population, it is observed that the two groups have similar opinions regarding the effects of tobacco on psychiatric symptoms and behaviors. The population hospitalized in the psychiatric hospital was the one that most agreed with the perception of the attitudes of professionals working in mental health services towards smoking, possibly due to situations experienced in the psychiatric hospital. Among the personal and clinical variables, the illiterate or those who studied up to primary/junior high school were the ones who most agreed that the smoking ban aggravates psychiatric symptoms.Conclusions: This study contribute to the practice of psychiatric nursing by disclosing the opinions and perceptions of attitudes associated with smoking in mental health services. Introducción: Las opiniones y percepciones acerca del tabaquismo de la población psiquiátrica contribuyen a que su prevalencia, en esa población, sea de dos a tres veces superior a la encontrada en otros grupos.Objetivos: 1) Comparar las opiniones de la población psiquiátrica y de la población general en relación a la prohibición de fumar, en los servicios de salud mental, así como comparar la percepción que tienen de las actitudes de profesionales de salud mental, en relación al tabaquismo; 2) Identificar la asociación entre variables personales y clínicas con las opiniones y percepciones de las actitudes.Método: Este estudio epidemiológico brasileño de corte transversal fue realizado en Ambulatorio de Salud Mental (n=126), en Hospital psiquiátrico (n=126) y en Unidad Básica de Salud (n=126). Fueron realizadas entrevistas individuales usando un cuestionario.Resultados: La mayoría de los participantes cree que los síntomas psiquiátricos pueden agravarse con la prohibición de fumar. Al comparar las respuestas de la población psiquiátrica con la población general, se observó que los dos grupos tienen opiniones similares acerca de los efectos del tabaco en los síntomas psiquiátricos y en el comportamiento. La población internada en el hospital psiquiátrico fue la que más concordó con las afirmaciones relacionadas a las actitudes de los profesionales que trabajan en los servicios de salud mental, en relación al tabaquismo, posiblemente debido a las situaciones que experimentan en el hospital psiquiátrico. Entre las variables personales y clínicas, los analfabetos y los que estudiaron hasta la enseñanza fundamental fueron los que más concordaron que la prohibición de fumar puede agravar los síntomas psiquiátricos.Conclusión: Este estudio contribuye para la práctica de la enfermería psiquiátrica, al revelar las opiniones y percepciones de actitudes relacionadas al tabaquismo, en los servicios de salud mental. Introdução: As opiniões e percepções acerca do tabagismo da população psiquiátrica contribuem para sua prevalência, nessa população, ser duas a três vezes superior à encontrada em outros grupos.Objetivo: 1) Comparar as opiniões da população psiquiátrica e da população geral em relação à proibição do fumo nos serviços de saúde mental, bem como a percepção que elas têm das atitudes dos profissionais de saúde mental em relação ao tabagismo; 2) Identificar a associação entre variáveis pessoais e clínicas com as opiniões e percepção das atitudes.Método: Este estudo epidemiológico brasileiro de corte transversal foi realizado em: Ambulatório de Saúde Mental (n=126), Hospital psiquiátrico (n=126) e Unidade Básica de Saúde (n=126). Foram conduzidas entrevistas individuais usando questionário.Resultados: A maioria dos participantes acredita que os sintomas psiquiátricos podem ser agravados com a proibição do fumo. Ao comparar as respostas da população psiquiátrica com as da população geral, é observado que os dois grupos têm opiniões similares acerca dos efeitos do tabaco nos sintomas psiquiátricos e no comportamento. A população internada no hospital psiquiátrico foi a que mais concordou com as afirmativas relacionadas às atitudes dos profissionais que trabalham nos serviços de saúde mental em relação ao tabagismo, possivelmente devido às situações que experienciam no hospital psiquiátrico. Dentre as variáveis pessoais e clínicas, os analfabetos e os que estudaram até o ensino fundamental foram os que mais concordaram que a proibição do fumo pode agravar os sintomas psiquiátricos.Conclusão: Este estudo contribui para a prática da enfermagem psiquiátrica ao revelar as opiniões e percepções das atitudes relacionadas ao tabagismo nos serviços de saúde mental.

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Nicotine receptor partial agonists for smoking cessation

Livingstone‐Banks

Fanshawe

Thomas

et al. 2023

Cochrane Database of Systematic Reviews

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Background Nicotine receptor partial agonists may help people to stop smoking by a combination of maintaining moderate levels of dopamine to counteract withdrawal symptoms (acting as an agonist) and reducing smoking satisfaction (acting as an antagonist). This is an update of a Cochrane Review first published in 2007. Objectives To assess the effectiveness of nicotine receptor partial agonists, including varenicline and cytisine, for smoking cessation. Search methods We searched the Cochrane Tobacco Addiction Group's Specialised Register in April 2022 for trials, using relevant terms in the title or abstract, or as keywords. The register is compiled from searches of CENTRAL, MEDLINE, Embase, and PsycINFO. Selection criteria We included randomised controlled trials that compared the treatment drug with placebo, another smoking cessation drug, e‐cigarettes, or no medication. We excluded trials that did not report a minimum follow‐up period of six months from baseline. Data collection and analysis We followed standard Cochrane methods. Our main outcome was abstinence from smoking at longest follow‐up using the most rigorous definition of abstinence, preferring biochemically validated rates where reported. We pooled risk ratios (RRs), using the Mantel‐Haenszel fixed‐effect model. We also reported the number of people reporting serious adverse events (SAEs). Main results We included 75 trials of 45,049 people; 45 were new for this update. We rated 22 at low risk of bias, 18 at high risk, and 35 at unclear risk. We found moderate‐certainty evidence (limited by heterogeneity) that cytisine helps more people to quit smoking than placebo (RR 1.30, 95% confidence interval (CI) 1.15 to 1.47; I 2 = 83%; 4 studies, 4623 participants), and no evidence of a difference in the number reporting SAEs (RR 1.04, 95% CI 0.78 to 1.37; I 2 = 0%; 3 studies, 3781 participants; low‐certainty evidence). SAE evidence was limited by imprecision. We found no data on neuropsychiatric or cardiac SAEs. We found high‐certainty evidence that varenicline helps more people to quit than placebo (RR 2.32, 95% CI 2.15 to 2.51; I 2 = 60%, 41 studies, 17,395 participants), and moderate‐certainty evidence that people taking varenicline are more likely to report SAEs than those not taking it (RR 1.23, 95% CI 1.01 to 1.48; I 2 = 0%; 26 studies, 14,356 participants). While point estimates suggested increased risk of cardiac SAEs (RR 1.20, 95% CI 0.79 to 1.84; I 2 = 0%; 18 studies, 7151 participants; low‐certainty evidence), and decreased risk of neuropsychiatric SAEs (RR 0.89, 95% CI 0.61 to 1.29; I 2 = 0%; 22 studies, 7846 participants; low‐certainty evidence), in both cases evidence was limited ...

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Improved Depressive Symptoms in Adults with Schizophrenia During a Smoking Cessation Attempt with Varenicline and Behavioral Therapy

Cited by 16 publications

References 55 publications

Neuropsychiatric safety of varenicline in the general and COPD population with and without psychiatric disorders: a retrospective cohort study in a real-world setting

Neuropsychiatric safety of varenicline in the general and COPD population with and without psychiatric disorders: a retrospective cohort study in a real-world setting

Opinion and perception of attitudes related to smoking and its prohibition in mental health services

Nicotine receptor partial agonists for smoking cessation

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