Safety and Effectiveness of Varenicline in a Veteran Population with a High Prevalence of Mental Illness

Abstract

Cautious treatment initiation and close monitoring of veterans initiated on varenicline are warranted. Furthermore, the results from this study demonstrate the need for prospective effectiveness trials to determine the clinical significance of the results.

Mental health stability in veterans with posttraumatic stress disorder receiving varenicline

“…This rate is consistent with the findings of Purvis et al 29 ; 8% of their study population experienced neuropsychiatric effects ranging from agitation and anxiety to a depressive episode in 1 individual. To date, serious adverse effects such as found in that study and this study have been documented only in case reports and not in other clinical trials.…”

“…Unless directly documented by providers upon follow-up, the last dose of medication for each patient was Variable Table 1. (29) Value assumed to occur at the end of a four-week course of treatment. This could skew the data if numerous patients discontinued therapy before completing the full varenicline prescription.…”

“…The results indicated no difference in the frequency of adverse effects experienced by patients with mental illness versus those without. Purvis et al 29 evaluated the safety and effectiveness of varenicline in a population including 24 MH patients at a Veterans Affairs medical center (VAMC). The prevalence of underlying mental illness in patients who successfully quit smoking (4 of 15, 27%) was significantly lower than in patients who were not successful (20 of 35, 57%) (p < 0.001).…”

Smoking Cessation Intervention: An Evidence-Based Approach

“…53 It is the first partial agonist of the α4β2 nicotinic acetylcholine receptor to be developed; the dependency effects of nicotine are thought to be mediated at these receptors. 54,55 Varenicline works by stimulating dopamine, which results in reduced cravings and withdrawal symptoms.…”

Smoking Cessation–Recent Advances

“…A small number of studies undertaken in populations with mental illness have subsequently been reported but they have been either uncontrolled or underpowered (or both) and therefore unable to properly assess the risk of this condition [32][33][34][35].…”