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. 2018 Sep 19:9:428.
doi: 10.3389/fpsyt.2018.00428. eCollection 2018.

Efficacy and Safety of Varenicline for Smoking Cessation in Schizophrenia: A Meta-Analysis

Saeed Ahmed  1 , Sanya Virani  2 , Vijaya P Kotapati  3 , Ramya Bachu  4 , Mahwish Adnan  5 , Ali M Khan  6 , Aarij Zubair  7 , Gulshan Begum  3 , Jeevan Kumar  8 , Mustafa Qureshi  9 , Rizwan Ahmed  10
Affiliations

Efficacy and Safety of Varenicline for Smoking Cessation in Schizophrenia: A Meta-Analysis

Saeed Ahmed et al. Front Psychiatry. .

Abstract

Objective: Smoking represents a major public health problem among patients with schizophrenia. To this end, some studies have investigated the efficacy of varenicline for facilitating smoking cessation in schizophrenia patients. The present review seeks to synthesize the results of these studies as well as document the reported side effects of using this medication. Methods: An electronic search was performed using five major databases: PubMed, Scopus, EMBASE, Web of Science, and Cochrane Library. Included in the current analysis were randomized clinical trials (RCTs) that have investigated the effect of varenicline in promoting smoking cessation in patients with schizophrenia. Risk of bias among included RCTs was assessed using the Cochrane Collaboration's quality assessment tool. Results: Among the 828 screened articles, only four RCTs, which involved 239 participants, were eligible for meta-analysis. In patients with schizophrenia, varenicline treatment when compared to placebo significantly reduced the number of cigarettes consumed per day [SMD (95% CI) = 0.89(0.57-1.22)] and expired carbon monoxide levels [SMD (95% CI) = 0.50 (0.06-0.94)] respectively. Conclusion: Despite a limited number of studies included in the meta-analysis, our results suggest that varenicline is an effective and safe drug to assist smoking cessation in patients with schizophrenia. Future large-scale well-designed RCTs are required to validate these findings.

Keywords: cigarettes; nicotine addiction; schizophrenia; smoking cessation; varenicline.

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Figures

Figure 1
Figure 1
PRISMA flow diagram of studies' selection and screening.
Figure 2
Figure 2
Summary of risk of bias assessment according to Cochrane collaboration tool.
Figure 3
Figure 3
Forest plot meta-analysis of three RCTs illustrating impact of varenicline compared to placebo on cigarette consumption in schizophrenia patients. SMD, standard mean difference; CI, confidence interval; RE, random effect.
Figure 4
Figure 4
Forest plot meta-analysis of two RCTs for the effect of varenicline compared to placebo on the expired carbon monoxide in schizophrenia patients. SMD, standard mean difference; CI, confidence interval; RE, random effect.
Figure 5
Figure 5
Forest plot meta-analysis of two RCTs for the impact of varenicline on abstaining from smoking behavior in schizophrenia patients. CI, confidence interval; RE, random effect.
See this image and copyright information in PMC

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