Effects of Varenicline and Bupropion Sustained-Release Use Plus Intensive Smoking Cessation Counseling on Prolonged Abstinence From Smoking and on Depression, Negative Affect, and Other Symptoms of Nicotine Withdrawal
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IMPORTANCE: Given the actions of varenicline tartrate and bupropion hydrochloride sustained-release (SR) on neurobiological targets related to affect and reward, it is thought that the modulation of nicotine withdrawal symptoms may contribute to their effectiveness. OBJECTIVE: To assess the relative efficacy of varenicline and bupropion SR plus intensive counseling on smoking cessation and emotional functioning. DESIGN AND SETTING: Placebo-controlled randomized clinical trial at a university medical center. PARTICIPANTS: In total, 294 community volunteers who wanted to quit smoking. INTERVENTIONS: Twelve weeks of varenicline, bupropion SR, or placebo plus intensive smoking cessation counseling (10 sessions, for a total of approximately 240 minutes of counseling). MAIN OUTCOME MEASURES: Prolonged abstinence from smoking and weekly measures of depression, negative affect, and other symptoms of nicotine withdrawal. RESULTS: Significant differences were found in abstinence at the end of treatment and through the 3-month postquit follow-up visit, favoring both active medications compared with placebo. At the 6-month postquit follow-up visit, only the varenicline vs placebo comparison remained significant. Varenicline use was also associated with a generalized suppression of depression and reduced smoking reward compared with the other treatments, while both active medications improved concentration, reduced craving, and decreased negative affect and sadness compared with placebo, while having little effect (increase or decrease) on anxiety and anger. No differences were noted in self-reported rates of neuropsychiatric adverse events. CONCLUSIONS AND RELEVANCE: In a community sample, varenicline exerts a robust and favorable effect on smoking cessation relative to placebo and may have a favorable (suppressive) effect on symptoms of depression and other affective measures, with no clear unfavorable effect on neuropsychiatric adverse events. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00507728.
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Changes in depression vary depending on the stop smoking medication used.
“Others have found changes in depression to vary depending on the stop smoking medication used [12].”
From Depression and smoking cessation: evidence from a smoking cessation clinic with 1-year follow-up (2017) · cites this paper as [12]
Short-term but not long-term administration of varenicline reduces anxiety during withdrawal.
“Specifically, short-term but not long-term administration of varenicline reduces anxiety during withdrawal.”
From Activation of α4β2*/α6β2* nicotinic receptors alleviates anxiety during nicotine withdrawal without upregulating nicotinic receptors (2014) · cites this paper as Cinciripini et al., 2013
Varenicline treatment does not improve nicotine withdrawal-induced anxiety.
“However, although varenicline has been shown to improve both concentration and depressed mood and mitigate craving, recent studies in mice and human subjects have shown treatment does not improve nicotine withdrawal-induced anxiety (Turner et al., 2013b;Cinciripini et al., 2013).”
From Activation of α4β2*/α6β2* nicotinic receptors alleviates anxiety during nicotine withdrawal without upregulating nicotinic receptors (2014) · cites this paper as Cinciripini et al., 2013
A recent study in smokers identified anxiety as one of the symptom domains in which varenicline treatment was ineffective.
“Additionally, a recent study in smokers identified anxiety as one of the symptom domains in which varenicline treatment was ineffective (Cinciripini et al., 2013).”
From Activation of α4β2*/α6β2* nicotinic receptors alleviates anxiety during nicotine withdrawal without upregulating nicotinic receptors (2014) · cites this paper as Cinciripini et al., 2013
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Cites
Development and validation of brief measures of positive and negative affect: The PANAS scales.
Watson, D., Clark, L. A., & Tellegen, A. (1988) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.54.6.1063 · Cited by 32,433 · see citing works
(1998) · The Journal of Clinical Psychiatry · Cited by 19,139 · see citing works
The Fagerstrom Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire
HEATHERTON, T. F., KOZLOWSKI, L. T., FRECKER, R. C., & FAGERSTROM, K. (1991) · British Journal of Addiction · doi:10.1111/j.1360-0443.1991.tb01879.x · Cited by 10,738 · see citing works
(1998) · PubMed · Cited by 10,216 · see citing works
Motivational interviewing: preparing people for change.
Miller, W. R., & Rollnick, S. (2002) · Cited by 7,002 · see citing works
The mini international neuropsychiatric interview
Lecrubier, Y., Sheehan, D. V., Hergueta, T., & Weiller, E. (1998) · European Psychiatry · doi:10.1016/s0924-9338(99)80239-9 · Cited by 5,882 · see citing works
Treating tobacco use and dependence-Clinical practice guideline
Mc, F. (2000) · Medical Entomology and Zoology · Cited by 3,616 · see citing works
Signs and Symptoms of Tobacco Withdrawal
Hughes, J. R. (1986) · Archives of General Psychiatry · doi:10.1001/archpsyc.1986.01800030107013 · Cited by 1,669 · see citing works
Jorenby, D. E. (2006) · JAMA · doi:10.1001/jama.296.1.56 · Cited by 1,635 · see citing works
Antidepressants for smoking cessation
Howes, S., Hartmann-Boyce, J., Livingstone-Banks, J., Hong, B., & Lindson, N. (2020) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000031.pub5 · Cited by 1,352 · see citing works
Treating tobacco use and dependence: 2008 update: Clinical practice guideline
(2008) · PsycEXTRA Dataset · doi:10.1037/e481882008-001 · Cited by 1,219 · see citing works
Measures of abstinence in clinical trials: issues and recommendations
Hughes, J. R., Keely, J. P., NIAURA, R. S., Ossip-Klein, D. J., RICHMOND, R. L., & Swan, G. E. (2003) · Nicotine & Tobacco Research · doi:10.1093/ntr/5.1.13 · Cited by 1,058 · see citing works
Varenicline: An α4β2 Nicotinic Receptor Partial Agonist for Smoking Cessation
Coe, J. W., Brooks, P. R., Vetelino, M. G., Wirtz, M. C., Arnold, E. P., Huang, J., Sands, S. B., Davis, T. I., Lebel, L. A., Fox, C. B., et al. (2005) · Journal of Medicinal Chemistry · doi:10.1021/jm050069n · Cited by 930 · see citing works
Nicotine receptor partial agonists for smoking cessation
Hey, K., Lancaster, T., & Bala, M. (2006) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006103 · Cited by 864 · see citing works
Quitting Smoking Among Adults — United States, 2001–2010
Tanoue, L. T. (2012) · Yearbook of Medicine · doi:10.1016/s0084-3873(12)00225-8 · Cited by 737 · see citing works
Some Conceptual and Statistical Issues in Analysis of Longitudinal Psychiatric Data
Gibbons, R. D. (1993) · Archives of General Psychiatry · doi:10.1001/archpsyc.1993.01820210073009 · Cited by 719 · see citing works
Bupropion: a review of its mechanism of antidepressant activity.
Ascher, J. A., Cole, J. O., Colin, J. N., Feighner, J. P., Ferris, R. M., Fibiger, H. C., Golden, R. N., Martin, P., Potter, W. Z., & Richelson, E. (1995) · PubMed · Cited by 680 · see citing works
Antidepressants for smoking cessation
Hughes, J. R., Stead, L. F., & Lancaster, T. (2007) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000031.pub3 · Cited by 567 · see citing works
Quitting smoking among adults--United States, 2001-2010.
(2011) · PubMed · Cited by 495 · see citing works
Reliability and validity of a smoking timeline follow-back interview.
Brown, R. A., Burgess, E. S., Sales, S. D., Whiteley, J. A., Evans, D. M., & Miller, I. W. (1998) · Psychology of Addictive Behaviors · doi:10.1037/0893-164x.12.2.101 · Cited by 491 · see citing works
Effectiveness of smoking cessation therapies: a systematic review and meta-analysis
Wu, P., Wilson, K., Dimoulas, P., & Mills, E. J. (2006) · BMC Public Health · doi:10.1186/1471-2458-6-300 · Cited by 484 · see citing works
Development and validation of the Wisconsin Smoking Withdrawal Scale.
Welsch, S. K., Smith, S. S., Wetter, D. W., Jorenby, D. E., Fiore, M. C., & Baker, T. B. (1999) · Experimental and Clinical Psychopharmacology · doi:10.1037//1064-1297.7.4.354 · Cited by 308 · see citing works
Self-citationSmoking during pregnancy and newborn neurobehavior
Law, K. L., Stroud, L. R., LaGasse, L. L., Niaura, R., Liu, J., & Lester, B. M. (2003) · PEDIATRICS · doi:10.1542/peds.111.6.1318 · Cited by 307 · see citing works
Singh, S., Loke, Y. K., Spangler, J. G., & Furberg, C. D. (2011) · Canadian Medical Association Journal · doi:10.1503/cmaj.110218 · Cited by 286 · see citing works
Ross, C. E., & Mirowsky, J. (1984) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a113819 · Cited by 255 · see citing works
Confirmatory factor analyses and reliability of the modified cigarette evaluation questionnaire
Cappelleri, J. C., Bushmakin, A. G., Baker, C. L., Merikle, E. P., Olufade, A. O., & Gilbert, D. G. (2006) · Addictive Behaviors · doi:10.1016/j.addbeh.2006.06.028 · Cited by 241 · see citing works
Development and validation of the Wisconsin Smoking Withdrawal Scale.
Welsch, S. K., Smith, S. S., Wetter, D. W., et al. (1999) · Experimental and Clinical Psychopharmacology · doi:10.1037/1064-1297.7.4.354 · Cited by 236 · see citing works
Self-citationKinnunen, T., Doherty, K., Militello, F. S., & Garvey, A. (1996) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.64.4.791 · Cited by 223 · see citing works
Damaj, M. I., Carroll, F. I., Eaton, J. B., Navarro, H. A., Blough, B. E., Mirza, S., Lukas, R. J., & Martin, B. R. (2004) · Molecular Pharmacology · doi:10.1124/mol.104.001313 · Cited by 212 · see citing works
West, R., Baker, C. L., Cappelleri, J. C., & Bushmakin, A. G. (2008) · Psychopharmacology · doi:10.1007/s00213-007-1041-3 · Cited by 203 · see citing works
A comparison of psychological and pharmacological treatment in smoking cessation
Fagerstr�m, K. O. (1982) · Journal of Behavioral Medicine · doi:10.1007/bf00846161 · Cited by 179 · see citing works
Random regression models: a comprehensive approach to the analysis of longitudinal psychiatric data.
Gibbons, R. D., Hedeker, D., WATERNAUX, C. M., & Davis, J. M. (1988) · PubMed · Cited by 172 · see citing works
Kinnunen, T., Doherty, K., Militello, F. S., et al. (1996) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.64.4.791 · Cited by 168 · see citing works
Williams, J. M., Anthenelli, R. M., Morris, C. D., Treadow, J., Thompson, J. R., Yunis, C., & George, T. P. (2012) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.11m07522 · Cited by 162 · see citing works
Suicidal Behavior and Depression in Smoking Cessation Treatments
Moore, T. J., Furberg, C. D., Glenmullen, J., Maltsberger, J. T., & Singh, S. (2011) · PLoS ONE · doi:10.1371/journal.pone.0027016 · Cited by 150 · see citing works
Varenicline Versus Bupropion SR or Placebo for Smoking Cessation: A Pooled Analysis
Nides, M. (2008) · American Journal of Health Behavior · doi:10.5993/ajhb.32.6.10 · Cited by 121 · see citing works
Varenicline versus bupropion SR or placebo for smoking cessation: a pooled analysis.
Nides, M. A., Glover, E. D., Reus, V. I., et al. (2009) · PubMed · doi:10.5555/ajhb.2008.32.6.664 · Cited by 110 · see citing works
Rennard, S. I., Hughes, J., Cinciripini, P. M., Králíková, E., Raupach, T., Arteaga, C., Aubin, L. S., Russ, C., & for the Flexible Quit Date Study Group (2011) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntr220 · Cited by 92 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 1
- [14]Pocock S 1983 Clinical trials New York John Wiley & Sons
Cited by
Sorted by citations
Anthenelli, R. M., Benowitz, N. L., West, R., St Aubin, L., McRae, T., Lawrence, D., Ascher, J., Russ, C., Krishen, A., & Evins, A. E. (2016) · The Lancet · doi:10.1016/s0140-6736(16)30272-0 · Cited by 1,177 · see citing works
Nicotine receptor partial agonists for smoking cessation
Cahill, K., Stead, L., & Lancaster, T. (2007) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006103.pub2 · Cited by 747 · see citing works
Nicotine receptor partial agonists for smoking cessation
Cahill, K., Lindson-Hawley, N., Thomas, K. H., Fanshawe, T. R., & Lancaster, T. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006103.pub7 · Cited by 433 · see citing works
Antidepressants for smoking cessation
Howes, S., Hartmann-Boyce, J., Livingstone-Banks, J., Hong, B., & Lindson, N. (2020) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000031.pub5 · Cited by 1,352 · see citing works
Smoking cessation for improving mental health
Taylor, G. M., Lindson, N., Farley, A., Leinberger-Jabari, A., Sawyer, K., te Water Naudé, R., Theodoulou, A., King, N., Burke, C., & Aveyard, P. (2021) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013522.pub2 · Cited by 266 · see citing works
Varenicline, Smoking Cessation, and Neuropsychiatric Adverse Events
Gibbons, R. D., & Mann, J. J. (2013) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2013.12121599 · Cited by 142 · see citing works
Depression and smoking cessation: evidence from a smoking cessation clinic with 1-year follow-up
Stepankova, L., Kralikova, E., Zvolska, K., Pankova, A., Ovesna, P., Blaha, M., & Brose, L. S. (2017) · Annals of Behavioral Medicine · doi:10.1007/s12160-016-9869-6 · Cited by 78 · see citing works
Evaluating the temporal relationships between withdrawal symptoms and smoking relapse.
Robinson, J. D., Li, L., Chen, M., Lerman, C., Tyndale, R. F., Schnoll, R. A., Hawk, L. W., George, T. P., Benowitz, N. L., & Cinciripini, P. M. (2019) · Psychology of Addictive Behaviors · doi:10.1037/adb0000434 · Cited by 74 · see citing works
Self-citationSterling, L. H., Windle, S. B., Filion, K. B., Touma, L., & Eisenberg, M. J. (2016) · Journal of the American Heart Association · doi:10.1161/jaha.115.002849 · Cited by 70 · see citing works
Yohn, N. L., Turner, J. R., & Blendy, J. A. (2014) · The Journal of Pharmacology and Experimental Therapeutics · doi:10.1124/jpet.113.211706 · Cited by 28 · see citing works
Yammine, L., Verrico, C. D., Versace, F., Webber, H. E., Suchting, R., Weaver, M. F., Kosten, T. R., Alibhai, H., Cinciripini, P. M., Lane, S. D., et al. (2023) · BMJ Open · doi:10.1136/bmjopen-2023-072707 · Cited by 13 · see citing works
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- Authors
- Cinciripini, P. M., Robinson, J. D., Karam-Hage, M., Minnix, J. A., Lam, C., Versace, F., Brown, V. L., Engelmann, J. M., & Wetter, D. W.
- Affiliations
- The University of Texas MD Anderson Cancer Center (US)
- ORCID
- Venue
- JAMA Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2013-05-01
- Volume
- 70
- Issue
- 5
- Pages
- 522
- ISSN
- 2168-622X (ISSN-L)
- PMC
- PMC4128024
- OpenAlex
- W2008817040
- Cited by
- 136
- References
- 39
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 6 · 2023: 15 · 2022: 9 · 2021: 5 · 2020: 14 · 2019: 6 · 2018: 10 · 2017: 9 · 2016: 14 · 2015: 14 · 2014: 11 · 2013: 13
- FWCI
- 12.30
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- JAMA Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (R01DA017073, R01DA032581, DA017073)
- National Cancer Institute ((P50-CA70907, P50CA070907, P30CA016672)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Nicotinic Acetylcholine Receptors Study
- Keywords
- varenicline, bupropion sustained release, smoking cessation, nicotine withdrawal symptoms, depression, negative affect, smoking abstinence, nicotine craving, neuropsychiatric adverse effects
- MeSH terms
- Varenicline, Adolescent, Adult, Affect, Aged, Benzazepines, Combined Modality Therapy, Counseling, Delayed-Action Preparations, Depression, Female, Humans, Male, Middle Aged, Nicotine, Quinoxalines, Smoking, Substance Withdrawal Syndrome, Smoking Cessation, Bupropion, Treatment Outcome, Nicotinic Agonists, Young Adult
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