title: Varenicline decreases alcohol consumption in heavy-drinking smokers.
abstract: BACKGROUND
  Emerging evidence suggests that the α4β2 form of the nicotinic acetylcholine receptor (nAChR) modulates the rewarding effects of alcohol. The nAChR α4β2 subunit partial agonist varenicline (Chantix™), which is approved by the Food and Drug Administration for smoking cessation, also decreases ethanol consumption in rodents (Steensland et al., Proc Natl Acad Sci U S A 104:12518-12523, 2007) and in human laboratory and open-label studies (Fucito et al., Psychopharmacology (Berl) 215:655-663, 2011; McKee et al., Biol Psychiatry 66:185-190 2009).
  
  
  OBJECTIVE
  We present a randomized, double-blind, 16-week study in heavy-drinking smokers (n = 64 randomized to treatment) who were seeking treatment for their smoking. The study was designed to determine the effects of varenicline on alcohol craving and consumption. Outcome measures included number of alcoholic drinks per week, cigarettes per week, amount of alcohol craving per week, cumulative cigarettes and alcoholic drinks consumed during the treatment period, number of abstinent days, and weekly percentage of positive ethyl glucuronide and cotinine screens.
  
  
  RESULTS
  Varenicline significantly decreases alcohol consumption (χ (2) = 35.32, p < 0.0001) in smokers. Although varenicline has previously been associated with suicidality and depression, side effects were low in this study and declined over time in the varenicline treatment group.
  
  
  CONCLUSIONS
  Varenicline can produce a sustained decrease in alcohol consumption in individuals who also smoke. Further studies are warranted to assess varenicline efficacy in treatment-seeking alcohol abusers who do not smoke and to ascertain the relationship between varenicline effects on smoking and drinking.
authors.affiliation: Ernest Gallo Clinic and Research Center, University of California, San Francisco, 5858 Horton Street, Suite #200, Emeryville, CA 94608, USA. jmitchell@gallo.ucsf.edu
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Mitchell
authors.forename: Candice H
authors.initials: CH
authors.lastname: Teague
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Kayser
authors.forename: Selena E
authors.initials: SE
authors.lastname: Bartlett
authors.forename: Howard L
authors.initials: HL
authors.lastname: Fields
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000517:prevention & control* / Q000523:psychology; D000437:Alcoholism / Q000517:prevention & control* / Q000523:psychology; D001552:Benzazepines / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D055991:Health Records, Personal; D006801:Humans; D008297:Male; D008875:Middle Aged; D018722:Nicotinic Agonists / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D011810:Quinoxalines / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D012907:Smoking / Q000188:drug therapy* / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology; D016896:Treatment Outcome; D000068580:Varenicline; D055815:Young Adult
chemical_list: D001552:Benzazepines; D018722:Nicotinic Agonists; D011810:Quinoxalines; D000068580:Varenicline