Efficacy and Safety of Pharmacotherapeutic Smoking Cessation Aids in Those With Schizophrenia Spectrum Disorders: A Subgroup Analysis of EAGLES
| Autor: | Melissa Culhane Maravic, Thomas McRae, Robert M. Anthenelli, Jaimee L. Heffner, Robert West, A. Eden Evins, Cristina Russ, Neal L. Benowitz, David Lawrence |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Subgroup analysis behavioral disciplines and activities Article 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Acquired immunodeficiency syndrome (AIDS) health services administration mental disorders medicine Humans 030212 general & internal medicine Nicotinic Agonists Psychiatry Varenicline Bupropion business.industry medicine.disease Nicotine replacement therapy Tobacco Use Cessation Devices 030227 psychiatry Psychiatry and Mental health chemistry Schizophrenia behavior and behavior mechanisms Smoking cessation Smoking Cessation business medicine.drug Schizophrenia spectrum |
| Zdroj: | Psychiatr Serv |
| Popis: | OBJECTIVE: Evaluate efficacy and safety of varenicline, bupropion, and nicotine replacement therapy (NRT) for smoking cessation in smokers with schizophrenia spectrum disorders in post-hoc analyses of EAGLES data. METHODS: Smokers with a schizophrenia spectrum disorder (n=390) and without a psychiatric illness (controls) (n=4,028) were randomly assigned to varenicline, bupropion, NRT, or placebo for 12 weeks. Outcomes included abstinence rates during treatment and follow-up, number needed to treat (NNT) for abstinence, incidence of neuropsychiatric adverse events, and temporal relationship between neuropsychiatric adverse events and abstinence status. RESULTS: Smokers with schizophrenia smoked more, had greater dependence, and fewer prior trials of cessation pharmacotherapy. At each timepoint, on varenicline, smokers with schizophrenia had significantly greater odds of abstinence than placebo and comparable NNT with controls. Bupropion and NRT increased odds of abstinence, though confidence intervals included one for some comparisons and produced greater NNT in smokers with schizophrenia than controls. No treatment was associated with significantly more neuropsychiatric adverse events than placebo in either cohort. The estimated neuropsychiatric adverse event rate was 5% (95% CI=3.0–7.7) in smokers with schizophrenia and 1% (95% CI=.6–2.1) in controls. Over one-third of neuropsychiatric adverse events occurred during partial or full abstinence, suggesting a multifactorial nature of neuropsychiatric adverse events. CONCLUSIONS: In smokers with schizophrenia, varenicline was associated with significantly higher abstinence rates than NRT, bupropion, and placebo, and had NNT comparable with smokers without psychiatric disorders. A significant proportion of neuropsychiatric adverse events occurred during early abstinence. No treatment significantly increased neuropsychiatric adverse event prevalence. |
| Databáze: | OpenAIRE |
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