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Randomized Controlled Trial
. 2014 Sep-Oct;23(5):459-65.
doi: 10.1111/j.1521-0391.2014.12130.x. Epub 2014 Mar 15.

Effects of varenicline, nicotine or placebo on depressive symptoms in postmenopausal smokers

Naomi Avery  1 , Anne M Kenny, Alison Kleppinger, Jennifer Brindisi, Mark D Litt, Cheryl A Oncken
Affiliations
Randomized Controlled Trial

Effects of varenicline, nicotine or placebo on depressive symptoms in postmenopausal smokers

Naomi Avery et al. Am J Addict. 2014 Sep-Oct.

Abstract

Background: Varenicline carries a black box warning for neuropsychiatric adverse events.

Objective: We examined varenicline use and past history of major depressive disorder (MDD) on depressive symptoms during smoking cessation.

Method: This is a secondary analysis of two smoking cessation studies in 152 postmenopausal women who received placebo or nicotine patch, or 78 women who received varenicline with relaxation. Lifetime history of MDD (LH-MDD) was assessed at baseline and women with current MDD were excluded. Center for Epidemiologic Study Depression scale (CESD) measured depressive symptoms at baseline, 6 and 12 weeks.

Results: Baseline CESD scores were 5.3 + 4.4. Those with a LH-MDD reported higher CESD scores (p > .001). Those taking varenicline reported lower scores over all time periods compared to nicotine or placebo (p < .01). The differences between varenicline and the other treatments remained when controlling for LH-MDD, indicating an independent effect. CESD scores were associated with concurrent smoking status (p < .001), and with withdrawal symptoms (p < .001).

Conclusion: CESD score were lower in those receiving varenicline, whether this is due to an anti-depressant effect, subject selection, use of relaxation or another cause is unknown. Varenicline does not increase depressive symptoms during smoking cessation in postmenopausal women without current MDD. Subjects with a LH-MDD are susceptible to developing depressive symptoms during smoking cessation, regardless of pharmacologic aid.

Scientific significance: Pharmacologic aids did not increase depression symptoms in this select population of postmenopausal women without current depression. Smoking cessation does increase depressive symptoms in those with LH-MDD, though the degree of increase was not clinically meaningful.

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Conflict of interest statement

Declaration of Interest No competing financial interests exist.

Figures

FIGURE 1
FIGURE 1
Estimated CESD scores (detransformed) by treatment sample. Results of linear mixed model analysis.
See this image and copyright information in PMC

References

    1. Hayatbakhsh MR, Najman JM, O’Callaghan MJ, et al. Association between smoking and respiratory function before and after menopause. Lung. 2011;189:65–71. - PubMed
    1. NIH State-of-the-Science Conference Statement on improving end-of-life care. NIH Consens State Sci Statements. 2004 Dec 6–8;21:1–26. - PubMed
    1. Copeland AL, Martin PD, Geiselman PJ, et al. Predictors of pretreatment attrition from smoking cessation among pre-and postmenopausal, weight-concerned women. Eat Behav. 2006;7:243–251. - PubMed
    1. Oncken C, Cooney J, Feinn R, et al. Transdermal nicotine for smoking cessation in postmenopausal women. Addict Behav. 2007;32:296–309. - PubMed
    1. Administration USFaD. Public Health Advisory: FDA Requires New Boxed Warnings for the Smoking Cessation Drugs Chantix and Zyban. Jul 01, 2009.

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