Categories
· Health/Science
· Cessation
· Mental Health/Neurology
· Vaccines
non-USA, by Country
· UK
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Jump to full article: British Medical Journal, 2009-10-01
Intro: Main findings
We found no clear evidence of an increased risk of self
harm associated with varenicline compared with other
smoking cessation products, although the limited study
power means we cannot rule out either a halving or a
twofold increase in risk. Analysis of those patients prescribed
varenicline suggested that they were likely to
be at lower risk of self harm than those prescribed nicotine
replacement products—they had lower levels of
past psychiatric consultation and previous self harm.
Nevertheless, controlling for these factors in multivariable
models did not alter our conclusions.Wefound no
evidence that varenicline increased the incidence of
suicidal thoughts. However, associations with suicidal
thoughts should be treated with caution as they are
under-recorded in the General Practice Research
Database (GPRD). Varenicline was associated with a
reduced risk of treated depression, as indexed by initiation
of antidepressant therapy. . . .
Conclusion
We found no clear evidence of an increased risk of self
harm, suicidal thoughts, or depression in people prescribed
varenicline compared with those prescribed
other smoking cessation products. In view of increasing
concerns about the possible increased risk of suicide
associated with these drugs and their increasing
popularity, further investigation of their effect on suicide
risk is required in other databases and through
secondary analysis of all adverse event reporting in
relevant clinical trials. Any such risk must be balanced
against the likely long term health benefits of smoking
cessation and the robust evidence of the effectiveness
of varenicline as an aid to smoking cessation.
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