varenicline

Reactions 1451 - 11 May 2013

SVarenicline

Neuropsychiatric events: 4 case reportsThree men and four women with psychiatric comorbidities

developed neuropsychiatric adverse events during treatmentwith varenicline for smoking cessation [routes and dosages notstated].

A 58-year-old man with PTSD developed worsening moodand suicidal ideation within 30 days of starting vareniclinetherapy. Varenicline was stopped and his suicidal thoughtsresolved.

A 39-year-old man with depression and PTSD beganexperiencing worsening mood with a passive death wish about35 days after varenicline initiation. He began receivingcitalopram, which was tapered off after varenicline was laterwithdrawn because his mood improved.

A 42-year-old woman with bipolar disorder developedemotional lability, depression and hallucinations from about7 days after starting varenicline. Twenty days after withdrawalof the drug, most of her symptoms had resolved.

A 49-year-old man with depression was hospitalised fordepression and suicidal ideation after a rechallenge of self-initiated varenicline. The man had initially taken it for 2 weeksbefore self-discontinuing due to low mood. After 5 weeks herestarted the drug, taking it for 3 weeks; he stopped a weekbefore the current admission. He began receiving fluoxetineand nicotine replacement, and received one session ofelectroconvulsive therapy. He was discharged after a 3-dayadmission, and required no further treatment for depressionsince discharge, despite becoming non-compliant withfluoxetine.

Author comment: "[W]e report four cases of varenicline-associated neuropsychiatric adverse effects".Cantrell M, et al. Adverse neuropsychiatric events associated with varenicline usein veterans: a case series. Issues in Mental Health Nursing 33: 665-9, No. 10, Oct2012 - USA 803086436

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Reactions 11 May 2013 No. 14510114-9954/10/1451-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved