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Am J Addict. 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.

Author information

1
Center on Aging, University of Connecticut Health Center, Farmington, Connecticut.

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.

PMID:
24628943
PMCID:
PMC5068915
DOI:
10.1111/j.1521-0391.2014.12130.x
[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

Declaration of Interest No competing financial interests exist.

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