Medicine and Health Sciences
Varenicline carries a black box warning for neuropsychiatric adverse events.
We examined varenicline use and past history of major depressive disorder (MDD) on depressive symptoms during smoking cessation.
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.
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).
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.
Avery, Naomi; Kenny, Anne M.; Kleppinger, Alison; Brindisi, Jennifer L.; Litt, Mark D.; and Oncken, Cheryl A., "Effects of Varenicline, Nicotine or Placebo on Depressive Symptoms in Postmenopausal Smokers" (2014). Articles - Patient Care. 91.