Among smokers taking varenicline, a probable lifetime history of depression was not associated with differential smoking abstinence rates at 3 months (OR 1.13) or qualitatively worse neuropsychiatric side effects compared to those without a depression history.
Cohort (n=1,177)
Yes
Does varenicline combined with behavioral therapy worsen mood or side-effects, or alter abstinence rates in smokers with a history of depression compared to those without?
Varenicline appears safe and equally effective for smoking cessation in patients with a history of depression compared to those without, without causing severe exacerbation of neuropsychiatric symptoms.
Odds Ratio: 1.13 (95% CI 0.89–1.42)
Absolute Event Rate: 44.8% vs 41.98%
p-value: p=0.32
BACKGROUND: Varenicline may be associated with greater mood disturbance and side-effects among smokers with psychiatric history, but empirical evidence is limited. Differential treatment effectiveness by psychiatric history may also exist. OBJECTIVE: To compare mood, prevalence and intensity of treatment side-effects, and abstinence among people with a probable history of major depression (DH+) or not (DH-) who took varenicline and received behavioral smoking cessation treatment. DESIGN: Smokers participated in a randomized behavioral intervention effectiveness trial. Treatment side-effects and outcomes were compared between DH+ and DH- participants (n = 1,117) at 21 corrected days and 3 months after the target quit date. PARTICIPANTS: Smokers recruited from a large regional health plan. MEASUREMENTS: Change in stress and depression scores, prevalence and intensity of treatment side-effects, and abstinence rates. RESULTS: All side-effects averaged moderate intensity or less and were similar across DH groups, except DH+'s endorsed slightly worse confusion, nausea (adjusted P = 0.04) and trouble sleeping (adjusted P = 0.008) at 21 days. Depression and stress scores declined in both DH groups and an equal proportion of each evidenced new/worsening depressive symptoms. Despite few differences in symptom intensity, more DH+ participants reported recent tension/agitation, irritability/anger, confusion, and depression at 21 days (adjusted P < 0.05), and depression and anxiety (adjusted P < 0.01) at three months. Nonsmoking rates did not differ by DH group at follow-up. CONCLUSION: While some group differences were noted, DH+ smokers did not report qualitatively worse neuropsychiatric symptoms, more new/worsening mood disturbance, or differential abstinence rates compared to DH- smokers.
McClure et al. (Mon,) conducted a cohort in Smoking cessation (n=1,177). Probable lifetime history of depression vs. No probable history of depression was evaluated on Point prevalent smoking abstinence at 3 months (OR 1.13, 95% CI 0.89-1.42, p=0.32). Among smokers taking varenicline, a probable lifetime history of depression was not associated with differential smoking abstinence rates at 3 months (OR 1.13) or qualitatively worse neuropsychiatric side effects compared to those without a depression history.