Mood, side-effects and smoking outcomes among persons with and without probable lifetime depression taking varenicline.
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.


METHODS
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.


METHODS
Smokers recruited from a large regional health plan.


METHODS
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.


CONCLUSIONS
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
Jennifer B
JB
Group Health Center for Health Studies, Seattle, WA 98101, USA. McClure.J@GHC.org
Swan
Gary E
GE
Jack
Lisa
L
Catz
Sheryl L
SL
Zbikowski
Susan M
SM
McAfee
Tim A
TA
Deprey
Mona
M
Richards
Julie
J
Javitz
Harold
H
D000328:Adult; D000339:Affect / Q000187:drug effects / Q000502:physiology; D001552:Benzazepines / Q000009:adverse effects* / Q000627:therapeutic use; D003866:Depressive Disorder / Q000188:drug therapy / Q000523:psychology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000139:chemically induced / Q000523:psychology; D011810:Quinoxalines / Q000009:adverse effects* / Q000627:therapeutic use; D012907:Smoking / Q000188:drug therapy / Q000523:psychology* / Q000628:therapy; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology*; D000068580:Varenicline
D001552:Benzazepines; D011810:Quinoxalines; D000068580:Varenicline