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Cited by 203Smoking Behavior and CessationNicotinic Acetylcholine Receptors StudySubstance Abuse Treatment and Outcomes

Effect of varenicline and bupropion SR on craving, nicotine withdrawal symptoms, and rewarding effects of smoking during a quit attempt

West, Robert, Baker, Christine L., Cappelleri, Joseph C., Bushmakin, Andrew G.·2008·Psychopharmacology
DOI 10.1007/s00213-007-1041-3
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Abstract

Aims To examine the effect of varenicline, a selective alpha4-beta2 nicotinic acetylcholine receptor (nAChR) partial agonist, on craving and withdrawal symptoms in smokers making a quit attempt and the rewarding effects of smoking during a lapse after the target quit date (TQD).Materials and methods Pooled data were analysed from two identical double-blind, randomised trials comparing varenicline 1 mg BID, bupropion (sustained release) 150 mg BID and placebo using measures of craving and withdrawal in the first week after the TQD (in abstinent [n = 612] and non-abstinent participants [n = 1,155]) and of the rewarding effects of the first cigarette smoked in non-abstinent participants.Results In abstinent and non-abstinent participants combined, varenicline reduced craving more than bupropion (p < 0.01) and placebo (p < .001); the effect did not differ by whether or not subjects were abstinent; bupropion reduced craving more than placebo (p < 0.001). Among abstinent participants, both varenicline and bupropion reduced negative affect more than those receiving placebo (p < 0.005). Neither active drug reduced restlessness, insomnia or appetite vs placebo. Varenicline reduced ratings of satisfaction and psychological reward after the first cigarette smoked after the TQD vs bupropion (p < 0.005) and placebo (p < 0.001); bupropion also reduced these more than placebo (p < 0.05).Conclusions Varenicline significantly reduces craving and the rewarding effects of smoking after the TQD to a greater extent than bupropion, which may contribute to varenicline's greater efficacy for smoking cessation. Varenicline's lack of effect in reducing insomnia, restlessness and increased appetite in this analysis suggests that receptors other than the alpha4-beta2 nAChR subtype may be implicated in these withdrawal symptoms.

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  • Clinical efficacy trials show that varenicline reduces smoking urges and withdrawal-related negative affect.

    “These trials document treatment-related reductions in smoking urges and withdrawal-related negative affect (4, 5, 9), as well as reduced smoking reward during a lapse (10).”

    From Varenicline improves mood and cognition during smoking abstinence (2009) · cites this paper as [9]

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Authors
West, R., Baker, C. L., Cappelleri, J. C., & Bushmakin, A. G.
Affiliations
  • Cancer Research UK (GB)
  • Pfizer (United States) (US)
Corresponding author
West, Robert
ORCID
Venue
Psychopharmacology
Publisher
Springer Science and Business Media LLC
Published
2007-12-15
Volume
197
Issue
3
Pages
371-377
ISSN
  • 0033-3158 (ISSN-L)
  • 1432-2072
DOI
10.1007/s00213-007-1041-3
OpenAlex
W2044625851
Cited by
203
References
21
Citations by year
2026: 4 · 2025: 2 · 2024: 4 · 2023: 9 · 2022: 5 · 2021: 8 · 2020: 13 · 2019: 6 · 2018: 10 · 2017: 6 · 2016: 6 · 2015: 8 · 2014: 10 · 2013: 16 · 2012: 14
FWCI
12.46
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Psychopharmacology (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Funders
  • Pfizer
  • Economic and Social Research Council (ES/G007489/1)
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Nicotinic Acetylcholine Receptors Study
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords
varenicline, bupropion, smoking cessation, nicotine craving, nicotine withdrawal symptoms, nicotine reward, nicotine receptor partial agonist, nicotine dependence, negative affect, insomnia, appetite, restlessness
MeSH terms
Varenicline, Adolescent, Adult, Affect, Aged, Benzazepines, Delayed-Action Preparations, Double-Blind Method, Follow-Up Studies, Humans, Middle Aged, Motivation, Nicotine, Quinoxalines, Substance Withdrawal Syndrome, Tobacco Use Disorder, Multicenter Studies as Topic, Randomized Controlled Trials as Topic, Smoking Cessation, Bupropion, Clinical Trials, Phase III as Topic, Nicotinic Agonists, Dopamine Uptake Inhibitors

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