Efficacy and Safety of Varenicline to Treat Nicotine Dependence in a Smokers Population with High Prevalence of Psychiatric Comorbidities

Abstract

Introduction Smokers with psychiatric comorbidities are prevalent in our current practice. Varenicline (Champix) is a first line pharmacotherapy indicated to treat nicotine addiction. Aim To assess efficacy and safety of varenicline in current practice of a smoking cessation center treating smokers with high prevalence of psychiatric disorders. Material and method 128 smokers with concurrent stable psychiatric, respiratory or cardiovascular disorders (study group) and 124 healthy smokers (control group) were treated with varenicline and counseling, for 12 weeks to stop smoking. Abstinence rate was assessed in both groups at 12 weeks. Varenicline safety, cessation profile and compliance to treatment were monitored in psychiatric disorders smokers compared to other co-morbidities and to controls. Results 54.6 % smokers with comorbidities (12/22 cardiovascular, 14/30 respiratory, 44/76 psychiatric) and 33.8 % healthy smokers successfully quit smoking. Withdrawal symptoms and adverse effects picture did not differ significantly between groups. The figure shows compliance to treatment and number of adverse events in healthy and psychiatric, respiratory and cardiovascular disease smokers. Compliance to treatment (%) Adverse effects (n) 2 weeks 4 weeks 8 weeks 12 weeks Healthy smokers (n=124) 80.6 80.6 77.4 72.5 11 Smokers with psychiatric disorders (n=76) 97.3 94.7 86.8 86.8 14 Smokers with respiratory disorders (n=30) 83.3 70 56.6 40 8 Smokers with cardiovascular disorders (n=22) 100 72.7 59 59 8 Conclusions Smokers with psychiatric co-morbidities achieved a higher abstinence rate, compared to respiratory and cardiovascular disease smokers and to control group. Varenicline proved comparable safety in both study and control groups.