title: The effects of varenicline on stress-induced and cue-induced craving for cigarettes.
abstract: BACKGROUND
  Varenicline is a partial agonist of the α4β2 nicotinic acetylcholine receptor approved by the FDA for the treatment of nicotine dependence. While the clinical efficacy of varenicline for smoking cessation is well-supported, its biobehavioral mechanisms of action remain poorly understood. This randomized, crossover, placebo-controlled, human laboratory study combines guided imagery stress exposure with in vivo presentation of cigarette cues to test the effects of varenicline on stress-induced and cue-induced craving for cigarettes.
  
  
  METHODS
  A total of 40 (13 females) daily smokers (≥10 cigarettes per day) completed a guided imagery exposure (stress and neutral) followed by the presentation of cigarette cues at the target dose of varenicline (1mg twice per day) and on matched placebo.
  
  
  RESULTS
  Multilevel regression models revealed a significant main effect of varenicline (p<.01) such that it reduced cigarette craving across the experimental paradigm, compared to placebo. There was also a significant medication×stress×trial interaction indicating that varenicline attenuated cue induced craving following neutral imagery but not when cues were preceded by stress induction (i.e., stress+cues).
  
  
  CONCLUSIONS
  These results elucidate the biobehavioral effects of varenicline for nicotine dependence and suggest that varenicline-induced amelioration of cigarette craving is unique to tonic craving and cue-induced craving following neutral imagery but does not extend to the combination of stress plus cues.
authors.affiliation: Department of Psychology, University of California-Los Angeles, CA, USA. lararay@psych.ucla.edu
authors.forename: Lara A
authors.initials: LA
authors.lastname: Ray
authors.forename: Katy
authors.initials: K
authors.lastname: Lunny
authors.forename: Spencer
authors.initials: S
authors.lastname: Bujarski
authors.forename: Nathasha
authors.initials: N
authors.lastname: Moallem
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Krull
authors.forename: Karen
authors.initials: K
authors.lastname: Miotto
mesh_terms: D000293:Adolescent; D000328:Adult; D016739:Behavior, Addictive / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D001552:Benzazepines / Q000627:therapeutic use*; D018592:Cross-Over Studies; D003463:Cues; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007092:Imagination; D008297:Male; D008875:Middle Aged; D018722:Nicotinic Agonists / Q000627:therapeutic use; D011810:Quinoxalines / Q000627:therapeutic use*; D012907:Smoking / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology; D013315:Stress, Psychological / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D016896:Treatment Outcome; D000068580:Varenicline; D055815:Young Adult
chemical_list: D001552:Benzazepines; D018722:Nicotinic Agonists; D011810:Quinoxalines; D000068580:Varenicline