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Varenicline Improves Mood and Cognition During Smoking Abstinence
Open accessAbstract
Background Neuronal nicotinic acetylcholine receptors (nAChRs) are a key target in medication development efforts for a range of neuropsychiatric disorders, including nicotine dependence. Varenicline, a partial agonist at the α4β2 nAChRs, is a new efficacious medication for nicotine dependence. Its effects on the affective and cognitive dimensions of nicotine withdrawal have yet to be well characterized. Methods Sixty-seven treatment-seeking smokers were administered varenicline (× 21 days) and placebo (× 21 days) in a double-blind within-subject cross-over design. Following the medication run-up phase (days 1–10), there was a 3-day mandatory smoking abstinence phase (days 11–13) during which subjective symptoms and cognitive performance were assessed. Participants were re-exposed to a scheduled smoking lapse (day 14) and followed for days to lapse (days 15–21) in each medication period. Results In the varenicline period, compared to placebo, withdrawal symptoms (p=.04), smoking urges (p<.001), and negative affect (p=.01) were significantly reduced, and levels of positive affect (p=.046), sustained attention (p=.018) and working memory (p=.001) were significantly greater during mandatory abstinence. Varenicline also significantly reduced the subjective rewarding effects of the scheduled smoking lapse (e.g., satisfaction, relief, liking) (p=.003). Medication effects on days to lapse following the scheduled smoking lapse were dependent on treatment order (p=.001); among participants who received placebo in the first period, varenicline increased days of abstinence in the follow-up period. Conclusions These data identify novel affective and cognitive effects of varenicline, and may have implications for medication development for other neuropsychiatric conditions.
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TL;DR
In a double-blind within-subject crossover study of 67 treatment-seeking smokers, varenicline reduced withdrawal, urges, negative affect, and smoking reward while improving positive affect, sustained attention, and working memory during 3-day mandatory abstinence. Varenicline increased days to lapse only among participants who received placebo first, revealing an order-dependent effect.
Key findings
- During mandatory abstinence (days 11–13), varenicline vs placebo significantly reduced withdrawal symptoms (p=.04), smoking urges (p<.001), and negative affect (p=.013), and increased positive affect (p=.046); effects were small to moderate (Cohen’s d = 0.26–0.42).
- Varenicline improved cognitive performance: Letter-N-back correct reaction time (F=11.08, p=.001; d=0.21), Penn Continuous Performance Task true positives (F=7.28, p=.009; d=0.33), and CPT correct reaction time (F=5.86, p=.018); no medication effect was found for N-back true positives (p=.98) or the Conditional Exclusion Test.
- Varenicline attenuated the subjective rewarding value of the scheduled lapse cigarette (F=9.25, p=.003; d=0.36), including satisfaction (p=.002; d=0.43), relief (p=.006; d=0.34), and liking (p=.001; d=0.41).
- Days to lapse showed a significant treatment-by-order interaction (F=11.99, p=.001): among placebo-first participants, mean days to lapse were 4.63 (SD=2.86) with varenicline vs 2.57 (SD=2.94) with placebo (Z=3.16, p=.002; d=0.71); among varenicline-first participants, means were 4.19 (SD=3.04) vs 4.94 (SD=2.87) (Z=1.34, p=.18; d=−0.25). Side effects reported as moderate or severe by over 5% occurred in 55.2% (37/67) on varenicline vs 28.4% (19/67) on placebo at day 10.
Methods
- Double-blind, placebo-controlled, within-subject crossover study of 67 treatment-seeking smokers (≥18 years, ≥10 cigarettes/day for previous 12 months; mean age 44.6 years, SD=11.6; 56.7% female; baseline mean 21.5 cigarettes/day, SD=10.0). Participants completed two 21-day medication periods (varenicline and placebo in counterbalanced order) with a 5–7 day washout; varenicline was titrated per standard guidelines, followed by a 10-day run-up, 3-day mandatory abstinence (days 11–13), scheduled smoking lapse (day 14), and follow-up days 15–21.
- Outcomes included subjective withdrawal symptoms, smoking urges, PANAS positive/negative affect, computerized neurocognitive tasks (Letter-N-back, Penn Continuous Performance Task, Conditional Exclusion Test) at baseline and day 13, Cigarette Evaluation Scale and Sensory Questionnaire after the lapse cigarette, CO-verified abstinence, medication adherence, and side-effect severity.
- Mixed effects models tested medication effects, controlling for sex, baseline cigarettes per day, and medication order; subjective models also included day 10 (smoking as usual) levels as a time-varying covariate, and neurocognitive models included baseline scores as a time-invariant covariate. Cohen’s d was calculated for raw varenicline–placebo differences.
Limitations
- The authors state that order effects were observed for the smoking abstinence outcome: varenicline increased days to lapse only among participants who received placebo first, not among those who received varenicline first. They suggest this may reflect greater self-efficacy after varenicline-induced abstinence success or longer-lasting nAChR modulation.
- The authors note recent reports of adverse psychiatric events with varenicline but state it is not possible to determine whether these events are partly attributable to nicotine withdrawal.
- Evident from the text: the abstinence phase was only 3 days and lapse follow-up only 7 days; several medication effects were small; the positive affect effect became nonsignificant when side-effect severity was included as a covariate (F=1.62, p=.21); side effects were more common on varenicline, which could affect blinding; and the sample excluded current or historical DSM-IV Axis I psychiatric disorders or substance abuse other than nicotine, limiting generalizability.
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Claims the paper makes
19 Not checked yet · 11 Own result · 9 Own method · 4 Own interpretation
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“During the varenicline period, compared to placebo, participants reported lower levels of withdrawal symptoms (p=.04), smoking urges (p<.001), and negative affect (p=.013).”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Results > Subjective Outcomes
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The 5–7 day washout period between the two medication periods was sufficient to eliminate carryover effects of varenicline.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“During the varenicline period, compared to placebo, participants reported lower levels of withdrawal symptoms (p=.04), smoking urges (p<.001), and negative affect (p=.013).”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Results > Subjective Outcomes
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The 5–7 day washout period between the two medication periods was sufficient to eliminate carryover effects of varenicline.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Significant effects were observed for satisfaction (F = 10.05, p = .002; d = 0.43), relief (F = 8.12, p = .006; d = 0.34), and liking (F = 11.09, p = .001; d = 0.41).”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Results > Smoking Reward and Days to Lapse
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The 5–7 day washout period between the two medication periods was sufficient to eliminate carryover effects of varenicline.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For days to lapse in the observation phase (days 15–21), there was a significant treatment by order interaction (F = 11.99, p = .001).”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Results > Smoking Reward and Days to Lapse
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The 5–7 day washout period between the two medication periods was sufficient to eliminate carryover effects of varenicline.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Significant effects were observed for satisfaction (F = 10.05, p = .002; d = 0.43), relief (F = 8.12, p = .006; d = 0.34), and liking (F = 11.09, p = .001; d = 0.41).”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Results > Smoking Reward and Days to Lapse
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The 5–7 day washout period between the two medication periods was sufficient to eliminate carryover effects of varenicline.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“compared to placebo, varenicline attenuated the subjective rewarding value of the scheduled lapse cigarette (day 14) (F = 9.25, p = .003; Cohen’s d = 0.36).”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Results > Smoking Reward and Days to Lapse
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The 5–7 day washout period between the two medication periods was sufficient to eliminate carryover effects of varenicline.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Significant effects were observed for satisfaction (F = 10.05, p = .002; d = 0.43), relief (F = 8.12, p = .006; d = 0.34), and liking (F = 11.09, p = .001; d = 0.41).”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Results > Smoking Reward and Days to Lapse
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The 5–7 day washout period between the two medication periods was sufficient to eliminate carryover effects of varenicline.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“All significant effects of treatment on outcomes remained significant, with the exception of the treatment effect in the model of positive affect, which became nonsignificant when the side effect measure was included (F=1.62, p=.21).”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Results > Medication Adherence and Side Effects
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Levels of positive affect were also greater during the varenicline period compared to placebo (p=.046).”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Results > Subjective Outcomes
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The 5–7 day washout period between the two medication periods was sufficient to eliminate carryover effects of varenicline.
None of the sources cited for this claim have been checked yet.
In the paper
“Varenicline, a partial agonist at the α4β2 nAChRs, and a full agonist at the α7 nAChRs, is a new, efficacious treatment for nicotine dependence (4–6).”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Introduction
What the sources say
- Not checked yetcites [4] Gonzales, 2006, Varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs sustained-release bupropion and placebo for smoking cessation: A randomized controlled trial, JAMA source
- Not checked yetcites [5] Jorenby, 2006, Efficacy of varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs placebo or sustained-release bupropion for smoking cessation: A randomized controlled trial, JAMA source
- Not checked yetcites [6] Mihalak, 2006, Varenicline is a partial agonist at alpha4beta2 and a full agonist at alpha7 neuronal nicotinic receptors, Mol Pharmacol source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 14
- The quote only partly states this claim. 1
- Probably not a substantial claim. 15
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Only baseline performance was significant in the models of CET true positives (p = .02) and correct reaction time (p < .001).”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Results > Neurocognitive Outcomes
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: The 5–7 day washout period between the two medication periods was sufficient to eliminate carryover effects of varenicline.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“in the model of CPT correct reaction time, there were effects of medication (F = 5.86, p = .018) and baseline performance (F = 117.1, p < .001).”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Results > Neurocognitive Outcomes
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
- Rests on an assumption: The 5–7 day washout period between the two medication periods was sufficient to eliminate carryover effects of varenicline.
In the paper
“Varenicline, a partial agonist at the α4β2 nAChRs, and a full agonist at the α7 nAChRs, is a new, efficacious treatment for nicotine dependence (4–6).”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Introduction
What the sources say
- Not checked yetcites [6] Mihalak, 2006, Varenicline is a partial agonist at alpha4beta2 and a full agonist at alpha7 neuronal nicotinic receptors, Mol Pharmacol source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Neuronal nicotinic acetylcholine receptors (nAChRs) are a key target of drug discovery efforts for nicotine dependence, as well as for neuropsychiatric conditions (3).”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Introduction
What the sources say
- Not checked yetcites [3] Arneric, 2007, Neuronal nicotinic receptors: A perspective on two decades of drug discovery research, Biochem Pharmacol source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Cronbach’s alphas for all scales ranged from .79 to .96.”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Methods and Materials > Subjective Outcomes
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The MINI International Neuropsychiatric Interview (MINI) was administered by trained research technicians to screen for psychiatric and substance abuse disorders (21). Ten percent of MINI interviews were recorded and reviewed by a licensed clinician.”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Methods and Materials > Procedures
What the sources say
- Not checked yetcites [21] Sheehan, 1998, The Mini-International Neuropsychiatric Interview (MINI): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10, J Clin Psychiatry
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The models of neurocognitive outcomes included baseline scores as a time-invariant covariate.”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Methods and Materials > Statistical Analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Varenicline produces a moderate level of nAChR stimulation and lower sustained levels of dopamine release, thereby replacing some of nicotine’s effects (7).”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Introduction
What the sources say
- Not checked yetcites [7] Coe, 2005, Varenicline: An alpha4beta2 nicotinic receptor partial agonist for smoking cessation, J Med Chem source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Aside from urges to smoke, the most common symptoms involve emotional dysregulation and cognitive deficits (13, 14).”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Discussion
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Further, competitive nAChR binding should, theoretically, reduce nicotine reward (7, 8).”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Introduction
What the sources say
- Not checked yetcites [7] Coe, 2005, Varenicline: An alpha4beta2 nicotinic receptor partial agonist for smoking cessation, J Med Chem source
- Not checked yetcites [8] Rollema, 2007, Rationale, pharmacology and clinical efficacy of partial agonists of alpha4beta2 nACh receptors for smoking cessation, Trends Pharmacol Sci source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“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).”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Introduction
What the sources say
- Not checked yetcites [4] Gonzales, 2006, Varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs sustained-release bupropion and placebo for smoking cessation: A randomized controlled trial, JAMA source
- Not checked yetcites [5] Jorenby, 2006, Efficacy of varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs placebo or sustained-release bupropion for smoking cessation: A randomized controlled trial, JAMA source
- Not checked yetcites [9] West, 2008, Effect of varenicline and bupropion SR on craving, nicotine withdrawal symptoms, and rewarding effects of smoking during a quit attempt, Psychopharmacology (Berl) source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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It may state two separate claims as one.
In the paper
“Depression symptoms are common among smokers and motivate smoking to reduce negative affect (44).”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Discussion
What the sources say
- Not checked yetcites [44] Lerman, 1996, Investigation of mechanisms linking depressed mood to nicotine dependence, Addict Behav source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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Probably not a substantial claim. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“There were no significant differences in these variables by medication order, nor were there any differences in smoking rate during the two run up periods (all Ps>.20).”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Results
plainn = 7- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“CO ≤ 10 ppm needed to confirm abstinence on days 11–13”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Methods and Materials > Procedures
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“All models controlled for sex, cigarettes per day at baseline, and order of medication phases.”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Methods and Materials > Statistical Analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The models of subjective outcomes also included day 10 (smoking as usual) levels of the measure as a time-varying covariate; thus, these models tested the effect of medication on changes in outcomes from pre-abstinence (day 10) to abstinence (mean of days 11–13).”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Methods and Materials > Statistical Analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“using validated computerized tasks: the Letter-N-back task of working memory (28), the Penn Continuous Performance Task (P-CPT) of sustained attention (29), and the Conditional Exclusion Test (CET) of abstraction in executive function (30, 31).”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Methods and Materials > Neurocognitive Outcomes
What the sources say
- Not checked yetcites [28] Ragland, 2002, Working memory for complex figures: An fMRI comparison of letter and fractal n-back tasks, Neuropsychology source
- Not checked yetcites [29] Kurtz, 2001, Comparison of the continuous performance test with and without working memory demands in healthy controls and patients with schizophrenia, Schizophr Res source
- Not checked yetcites [30] Kurtz, 2004, The Penn Conditional Exclusion Test: A new measure of executive-function with alternate forms of repeat administration, Arch Clin Neuropsychol source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“In this placebo-controlled double-blind crossover study, participants completed two 21-day medication periods (varenicline and placebo in counterbalanced order) and a 5–7 day washout period (four participants had longer washout periods due to scheduling issues) (see Figure 1).”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Methods and Materials > Procedures
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“In chronic smokers, abstinence from nicotine increases the availability of unbound α4β2 nAChRs, which in turn contributes to abstinence symptoms (35).”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Discussion
What the sources say
- Not checked yetcites [35] Staley, 2006, Human tobacco smokers in early abstinence have higher levels of beta2* nicotinic acetylcholine receptors than nonsmokers, J Neurosci source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Mean adherence levels were 99.27% for the placebo period and 98.70% for the varenicline period (Z = 1.89, p = .06 by Wilcoxon test).”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Results > Medication Adherence and Side Effects
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Participants who did not remain abstinent (n=3) were excluded.”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Methods and Materials > Procedures
plainn = 3- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Data from the present study indicate that varenicline, a partial agonist at the α4β2 nAChRs, enhances mood and cognitive function during early abstinence from nicotine.”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Discussion
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: The 5–7 day washout period between the two medication periods was sufficient to eliminate carryover effects of varenicline.
In the paper
“Prior evidence for the cognitive enhancing effects of selective nAChR agonists suggests further that varenicline might have additional potential benefits in this area beyond those specific to nicotine withdrawal (52).”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Discussion
What the sources say
- Not checked yetcites [52] Mineur, 2007, Cytisine, a partial agonist of high-affinity nicotinic acetylcholine receptors, has antidepressant-like properties in male C57BL/6J mice, Neuropharmacology source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, the data suggest two novel and potentially important clinical effects of varenicline, namely enhancement of positive affect and cognitive function.”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > Discussion
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper relies on this without support.
The 5–7 day washout period between the two medication periods was sufficient to eliminate carryover effects of varenicline.
“a 5–7 day washout period (four participants had longer washout periods due to scheduling issues)”
The paper relies on this without support.
The sample of treatment-seeking smokers is representative enough to generalize the study's findings to clinical populations of smokers attempting to quit.
“To increase the generalizability of results to the clinical setting, we enrolled treatment-seeking smokers (those planning to quit in the next 3 months) (19, 20).”
The paper relies on this without support.
The placebo capsule was indistinguishable from the active medication, so blinding was maintained.
“The placebo was a sucrose capsule that resembled the active medication (active medication was encapsulated also).”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Clinically, varenicline has demonstrated enhancement of both positive affect and cognitive function during smoking cessation (Patterson et al., 2009), and it was recently shown to augment the effects of antidepressants in depressed smokers (Philip et al., 2009).”
From Nicotinic Partial Agonists Varenicline and Sazetidine-A Have Differential Effects on Affective Behavior (2010) · cites this paper as Patterson et al., 2009
In the citing paper
“In clinical studies, administration of varenicline during smoking cessation results in the improvement of both positive affect and cognitive function (Patterson et al., 2009).”
From Nicotinic Partial Agonists Varenicline and Sazetidine-A Have Differential Effects on Affective Behavior (2010) · cites this paper as Patterson et al., 2009
Statistics recomputed
Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.
- Consistentz = 3.16reported p = .002 · recomputed p = .002
“(Z=3.16, p = .002”
- Consistentz = 1.34reported p = .18 · recomputed p = .180
“(Z=1.34, p = .18”
- Consistentz = 1.89reported p = .06 · recomputed p = .059
“(Z = 1.89, p = .06”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > References
“2007 December, 2007”
§ Varenicline Improves Mood and Cognition during Smoking Abstinence > References
“[cited 2007 November 16, 2007]”
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“investigations (a recent article, however, reports that RJR-2403 (a4b2-selective agonist) and PNU-282987 (a7-selective agonist) lack efficacy in the forced swim test and the tail-suspension test in mice) (Picciotto et al., 2008; Philip et al., 2009; Lodge and Li, 2008; Patterson et al., 2009; George et al., 2008; Popi…”
BackgroundNeuroscience of Behavioral and Pharmacological Treatments for Addictions
Potenza, M. N., Sofuoglu, M., Carroll, K. M., & Rounsaville, B. J. (2011) · Neuron · doi:10.1016/j.neuron.2011.02.009 · Cited by 220
“Similarly, varenicline, a partial agonist for the alpha4beta2 nicotinic receptors, attenuates the rewarding effects of nicotine (Patterson et al., 2009; Sofuoglu et al., 2009; West et al., 2008) and is effective for the treatment of nicotine dependence (Table 1).”
InfluentialGunnell, D., Irvine, D., Wise, L., Davies, C., & Martin, R. M. (2009) · BMJ · doi:10.1136/bmj.b3805 · Cited by 200
“However, these trials find no evidence of a greater adverse effect of varenicline on sleep or irritability compared with placebo, though there is evidence that varenicline increases the incidence of vivid dreams and increased frequency of dreams. In our analysis, those receiving varenicline were less likely to initiat…”
BackgroundInfluentialWorking memory deficits predict short-term smoking resumption following brief abstinence
Patterson, F., Jepson, C., Loughead, J., Perkins, K. A., Strasser, A. A., Siegel, S. J., Frey, J. M., Gur, R. C., & Lerman, C. E. (2009) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2009.07.020 · Cited by 190
“Standard exclusion criteria for varenicline were used (Patterson et al., 2009).”
InfluentialSelf-citationPhilip, N. S., Carpenter, L. L., Tyrka, A. R., & Price, L. H. (2010) · Psychopharmacology · doi:10.1007/s00213-010-1932-6 · Cited by 191
“To evaluate the effects of varenicline on mood and cognition during smoking cessation, Patterson et al. (2009) performed a double-blind placebo-controlled study in 67 subjects undergoing smoking cessation with a scheduled smoking relapse.”
Cognitive function during nicotine withdrawal: Implications for nicotine dependence treatment
Ashare, R. L., Falcone, M., & Lerman, C. (2014) · Neuropharmacology · doi:10.1016/j.neuropharm.2013.04.034 · Cited by 170
“The majority of laboratory studies reviewed above included smokers who were not currently interested in quitting, with a few exceptions (Culhane et al., 2008; Dolan et al., 2004; Krishnan-Sarin et al., 2007; Patterson et al., 2009).”
InfluentialSelf-citationCognitive enhancement as a pharmacotherapy target for stimulant addiction
Sofuoglu, M. (2009) · Addiction · doi:10.1111/j.1360-0443.2009.02791.x · Cited by 159
“, unpublished) Physostigmine [72] or rivastigmine [73] attenuate subjective effects of amphetamines Nicotinic and muscarinic receptors Varenicline Cholinergic system Improve attention and working memory in cigarette smokers [78] Not examined Nicotinic receptors Atomoxetine Noradrenergic system Improve response inhibit…”
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“Data from randomized controlled trials of nonpsychiatric populations showed no major psychiatric symptom exacerbations(90) or even improvement in mood.(87,91) We observed no excessive somatic or psychiatric symptoms using the current dosing, which is consistent with the prediction based on phase 2 data in which a 1-mg…”
Sutherland, M. T., Carroll, A. J., Salmeron, B. J., Ross, T. J., Hong, L. E., & Stein, E. A. (2013) · Biological Psychiatry · doi:10.1016/j.biopsych.2013.01.035 · Cited by 134
“reduces abstinence-induced affective and cognitive disturbances, as well as the subjective rewarding aspects of a smoked cigarette (40).”
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Self-citationPersistent β 2 *-Nicotinic Acetylcholinergic Receptor Dysfunction in Major Depressive Disorder
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“com/wt/page/tc_5214), and varenicline have been shown to have antidepressant effects in depression (22).”
BackgroundRollema, H., Hajós, M., Seymour, P. A., Kozak, R., Majchrzak, M. J., Guanowsky, V., Horner, W. E., Chapin, D. S., Hoffmann, W. E., Johnson, D. E., et al. (2009) · Biochemical Pharmacology · doi:10.1016/j.bcp.2009.05.033 · Cited by 118
Effects of Varenicline on Abstinence and Smoking Reward Following a Programmed Lapse
McClure, E. A., Vandrey, R. G., Johnson, M. W., & Stitzer, M. L. (2012) · Nicotine & Tobacco Research · doi:10.1093/ntr/nts101 · Cited by 112
“Using this lapse model, Patterson et al. (2009) showed that varenicline, compared with placebo, improved mood and cognition, decreased the subjective rewarding effects of a smoking lapse, and increased latency to relapse in a subsequent 1-week quit attempt.”
BackgroundMethodResultInfluentialShim, J.-C., Jung, D.-U., Jung, S. S., Seo, Y.-S., Cho, D.-M., Lee, J.-H., Lee, S.-W., Kong, B.-G., Kang, J.-W., Oh, M., et al. (2011) · Neuropsychopharmacology · doi:10.1038/npp.2011.238 · Cited by 112
“Others have also reported cognitive improvements in non-psychiatric populations in attention (Patterson et al, 2009) and working memory (Loughead et al, 2010; Patterson et al, 2009) that are similar to what is observed in animal studies (Rollema et al, 2007).”
BackgroundResultThe dose effects of short-term dronabinol (oral THC) maintenance in daily cannabis users
Vandrey, R. G., Stitzer, M. L., Mintzer, M. Z., Huestis, M. A., Murray, J. A., & Lee, D. (2012) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2012.08.001 · Cited by 106
“…and rewarding effects of smoking is believed to be instrumental in the improved initial abstinence success and relapse prevention rates observed among smokers using the medication during a quit attempt (McClure et al., 2012; Patterson et al., 2009; Perkins et al., 2010; West et al., 2008).”
BackgroundSmoking Behaviour and Mental Health Disorders—Mutual Influences and Implications for Therapy
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“Furthermore, in a small, open-label study involving 14 smokers with schizophrenia, varenicline demonstrated a beneficial effect on the cognitive dimensions of nicotine withdrawal [140], similar to effects observed in healthy smokers [141].”
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“Although the effects were small, varenicline improved sustained attention (as measured by the Penn Continuous Performance Task) and working memory (as measured by the letter N-back task; Patterson et al. 2009).”
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“In another crossover study, smokers (n=67)exhibited improvedsustainedattention(Cohen's d 0.33) and working memory (Cohen's d 0.21) during abstinence after 21 days of varenicline as compared to placebo (Patterson et al., 2009).”
MethodInfluentialNicotine receptor partial agonists for smoking cessation
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“In addition, varenicline improves the cognitive deficits associated with smoking cessation (Patterson et al. 2009).”
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“For instance, the effects of nicotine on cognitive processes are thought to play an important role in both the development and maintenance of addiction (Gutkin, Dehaene, & Changeux, 2006; Kenney & Gould, 2008a; Patterson et al., 2009; Watkins, Koob, & Markou, 2000).”
BackgroundTranscranial Direct Current Brain Stimulation Increases Ability to Resist Smoking
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“Studies in non-psychotic smokers [40] and in smokers with schizophrenia [41, 42] provide evidence to support the idea that varenicline may counter some of the neurocognitive deficits that smokers experience during the early phase of smoking abstinence.”
BackgroundCellular, molecular, and genetic substrates underlying the impact of nicotine on learning
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“The observed improvement in psychiatric symptoms is consistent with other early evidence from prospective trials that varenicline improves mood and cognition in smokers with diagnoses of major depressive disorder or schizophrenia, as well as those with no identified psychiatric illness (Patterson et al., 2009; Philip…”
Recent Developments in Novel Antidepressants Targeting α4β2-Nicotinic Acetylcholine Receptors
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The First 7 Days of a Quit Attempt Predicts Relapse
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“Although findings from the current clinical trials may not extend to acute laboratory studies, initial validation studies suggested that, compared with placebo, transdermal nicotine and varenicline increased the number of days of abstinence during the first week among smokers with high motivation to quit (Perkins et a…”
Self-citationFunctional Neurocircuits and Neuroimaging Biomarkers of Tobacco Use Disorder
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“Accordingly, varenicline has been reported to reduce withdrawal-induced affective and cognitive disturbances in human smokers as well as the subjective rewarding aspects of cigarette smoking [20].”
BackgroundAge‐related differences in working memory deficits during nicotine withdrawal
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“Moreover, effective smoking cessation medications reverse these deficits in rodent models and in human smokers (Portugal & Gould 2008; Patterson et al. 2009).”
BackgroundSelf-citationTargeting GLP-1 receptors to reduce nicotine use disorder: Preclinical and clinical evidence
Herman, R. J., & Schmidt, H. D. (2024) · Physiology & Behavior · doi:10.1016/j.physbeh.2024.114565 · Cited by 54
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Cross-Validation of a New Procedure for Early Screening of Smoking Cessation Medications in Humans
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Self-citationThe Nicotinic Acetylcholine Receptor as a Target for Antidepressant Drug Development
Philip, N. S., Carpenter, L. L., Tyrka, A. R., & Price, L. H. (2012) · The Scientific World JOURNAL · doi:10.1100/2012/104105 · Cited by 43
“Large clinical trials for smoking cessation showed improvement in depressive symptoms associated with nicotine withdrawal [54, 55], and subsequent examinations found improved mood and cognition in subjects using varenicline for smoking cessation [56].”
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“Besides reducing the urge to smoke, it has been shown to reduce withdrawal symptoms and to modify cognitive and affective symptoms that lead to relapse [30].”
BackgroundNicotinic Receptors, Memory, and Hippocampus
Kutlu, M. G., & Gould, T. J. (2015) · Current topics in behavioral neurosciences · doi:10.1007/978-3-319-13665-3_6 · Cited by 42
New insights on the effects of varenicline on nicotine reward, withdrawal and hyperalgesia in mice
Bağdaş, D., Alkhlaif, Y., Jackson, A. B., Carroll, F. I., Ditre, J. W., & Damaj, M. I. (2018) · Neuropharmacology · doi:10.1016/j.neuropharm.2018.05.025 · Cited by 42
Optimizing treatments for nicotine dependence by increasing cognitive performance during withdrawal
Ashare, R. L., & Schmidt, H. D. (2014) · Expert Opinion on Drug Discovery · doi:10.1517/17460441.2014.908180 · Cited by 40
“Varenicline increases cognitive performance during smoking abstinence and reduces the subjective rewarding effects of nicotine in humans [20,29,30].”
BackgroundEffects of varenicline and bupropion on cognitive processes among nicotine-deprived smokers.
Ashare, R. L., & McKee, S. A. (2011) · Experimental and Clinical Psychopharmacology · doi:10.1037/a0025594 · Cited by 41
“Thus, recent research has focused on cognitive processes as putative factors associated with relapse (Acheson & de Wit, 2008; Patterson et al., 2009; Sofuoglu, Herman, Mooney, & Waters, 2009).”
BackgroundResultInfluentialMeasures and predictors of varenicline adherence in the treatment of nicotine dependence
Peng, A. R., Morales, M., Wileyto, E. P., Hawk, L. W., Cinciripini, P. M., George, T. P., Benowitz, N. L., Nollen, N. L., Lerman, C. E., Tyndale, R. F., et al. (2017) · Addictive Behaviors · doi:10.1016/j.addbeh.2017.07.006 · Cited by 36
“Participants also completed a checklist of common side effects associated with smoking cessation medications (e.g., trouble sleeping, nausea) (McClure et al., 2009; Patterson et al., 2009; Schnoll et al., 2009) and rated each by severity (from none [0] to severe [3]).”
BackgroundSelf-citationSchnoll, R. A., Leone, F. T., Veluz‐Wilkins, A. K., Miele, A., Hole, A. V., Jao, N. C., Wileyto, E. P., Carroll, A. J., Kalhan, R., Patel, J. D., et al. (2019) · Psycho-Oncology · doi:10.1002/pon.4978 · Cited by 42
“Varenicline mitigates the adverse psychological effects and withdrawal‐related cognitive impairment associated with quitting smoking.(21,22) We have shown in the general population that extending the use of transdermal nicotine to 24 weeks increases quit rates, vs 8 weeks, and significantly reduces the probability of…”
BackgroundReward Anticipation Is Differentially Modulated by Varenicline and Nicotine in Smokers
Fedota, J. R., Sutherland, M. T., Salmeron, B. J., Ross, T. J., Hong, L. E., & Stein, E. A. (2015) · Neuropsychopharmacology · doi:10.1038/npp.2015.54 · Cited by 37
Mocking, R. J. T., Pflanz, C. P., Pringle, A., Parsons, E., McTavish, S. F. B., Cowen, P. J., & Harmer, C. J. (2012) · Neuropsychopharmacology · doi:10.1038/npp.2012.205 · Cited by 38
“These results are more consistent with previous research, which suggests potential antidepressant activity (Patterson et al, 2009; Philip et al, 2009; Mineur and Picciotto, 2010), than data suggesting depressogenic effects.”
BackgroundResultAn open-label pilot trial ofN-acetylcysteine and varenicline in adult cigarette smokers
McClure, E. A., Baker, N. L., Gipson, C. D., Carpenter, M. J., Roper, A. P., Froeliger, B., Kalivas, P. W., & Gray, K. M. (2014) · The American Journal of Drug and Alcohol Abuse · doi:10.3109/00952990.2014.933839 · Cited by 38
Roiko, S. A., Harris, A. C., LeSage, M. G., Keyler, D. E., & Pentel, P. R. (2009) · Pharmacology Biochemistry and Behavior · doi:10.1016/j.pbb.2009.04.011 · Cited by 38
“(2006) reported that only three cigarette puffs produced 75% occupancy of α4ß2⁎ nAChRs, a high affinity nAChR subtype implicated in withdrawal (Epping-Jordan et al., 1998; Rahman et al., 2008; Patterson et al., 2008).”
Nocente, R., Vitali, M., Balducci, G., Enea, D., Kranzler, H. R., & Ceccanti, M. (2013) · American Journal on Addictions · doi:10.1111/j.1521-0391.2013.12037.x · Cited by 37
Jain, R., Jhanjee, S., Jain, V., Gupta, T., Mittal, S., Goelz, P. M., Wileyto, E. P., & Schnoll, R. A. (2013) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntt115 · Cited by 36
Ashare, R. L., Tang, K. Z., Mesaros, A. C., Blair, I. A., Leone, F. T., & Strasser, A. A. (2012) · Journal of Psychopharmacology · doi:10.1177/0269881112449397 · Cited by 37
“Side effects were monitored at each visit, consistent with previous varenicline research in our center (Patterson et al., 2009).”
BackgroundMethodResultInfluentialSelf-citationSutherland, M. T., Ross, T. J., Shakleya, D. M., Huestis, M. A., & Stein, E. A. (2010) · Psychopharmacology · doi:10.1007/s00213-010-2013-6 · Cited by 39
“More protracted periods of smoking deprivation (>12 h) than assessed herein impair WM performance with smoking, nicotine, or varenicline ameliorating such deficits (Ernst et al. 2001a; Jacobsen et al. 2005; Jacobsen et al. 2007; Mendrek et al. 2006; Patterson et al. 2009; Xu et al. 2005).”
BackgroundRoche, D. J. O., Ray, L. A., Yardley, M. M., & King, A. C. (2016) · Current Addiction Reports · doi:10.1007/s40429-016-0081-3 · Cited by 39
Phase II Crossover Trial of Varenicline in Mild-to-Moderate Alzheimer's Disease
Kim, S. Y., Choi, S. H., Rollema, H., Schwam, E. M., McRae, T., Dubrava, S., & Jacobsen, J. (2013) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000355373 · Cited by 39
The effects of varenicline on attention and inhibitory control among treatment-seeking smokers
Rhodes, J. D., Hawk, L. W., Ashare, R. L., Schlienz, N. J., & Mahoney, M. C. (2012) · Psychopharmacology · doi:10.1007/s00213-012-2700-6 · Cited by 34
Levin, E. D., Hao, I., Burke, D. A., Cauley, M. C., Hall, B. J., & Rezvani, A. H. (2014) · Journal of Psychopharmacology · doi:10.1177/0269881114543721 · Cited by 34
“Indeed, although reports are somewhat mixed, there is evidence that varenicline, the only nicotinic ligand currently approved by FDA for smoking cessation, may improve working memory performance, particularly during periods of abstinence in smokers (Loughead et al., 2010; Patterson et al., 2009).”
BackgroundNewman, A. H., Xi, Z., & Heidbreder, C. A. (2022) · Current topics in behavioral neurosciences · doi:10.1007/7854_2022_347 · Cited by 41
Harrison, J. D., Dochney, J. A., Blazekovic, S., Leone, F. T., Metzger, D. S., Frank, I., Gross, R., Hole, A. V., Mounzer, K., Siegel, S. J., et al. (2017) · Journal of NeuroVirology · doi:10.1007/s13365-017-0526-z · Cited by 33
“, varenicline) (Patterson et al. 2009) might be beneficial additions to tobacco cessation programs for HIV-infected smokers, perhaps with extended treatment to ensure enhanced cognitive function and reduced relapse risk.”
Self-citationSaravia, R., Flores, Á., Plaza‐Zabala, A., Busquets-García, A., Pastor, A., de la Torre, R., Marzo, V. D., Marsicano, G., Ozaita, A., Maldonado, R. J., et al. (2016) · Biological Psychiatry · doi:10.1016/j.biopsych.2016.07.007 · Cited by 32
“These effects seem to be important for the efficacy of varenicline as a smoking cessation agent (8).”
Impact of Substance Use Disorder Pharmacotherapy on Executive Function: A Narrative Review
Butler, K., & Foll, B. L. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00098 · Cited by 31
“(75) showed that in abstinent smokers varenicline, vs.”
BackgroundInfluentialSofuoglu, M., Herman, A. I., Mooney, M. E., & Waters, A. J. (2009) · Psychopharmacology · doi:10.1007/s00213-009-1643-z · Cited by 32
“In a recent study, varenicline treatment improved performance in sustained attention and working memory tasks in abstinent smokers (Patterson et al. 2009).”
InfluentialHitsman, B. L., Hogarth, L., Tseng, L., Teige, J. C., Shadel, W. G., DiBenedetti, D. B., Danto, S. I., Lee, T. C., Price, L. H., & NIAURA, R. S. (2012) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2012.10.021 · Cited by 34
“The therapeutic effect of varenicline on smoking cessation is mediated in part by its attenuation of cigarette craving, smoking reward, and withdrawal severity (Patterson et al. 2009; Perkins et al., 2010; Sofuoglu et al., 2009; West et al., 2008).”
BackgroundVarenicline modulates spatial working memory deficits in smokers with schizophrenia
Wing, V. C., Wass, C., Bacher, I., Rabin, R. A., & George, T. P. (2013) · Schizophrenia Research · doi:10.1016/j.schres.2013.06.032 · Cited by 30
Cognitive effects of labeled addictolytic medications
Pujol, C., Paasche, C., Laprévote, V., Trojak, B., Vidailhet, P., Bacon, É., & Lalanne, L. (2017) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2017.09.008 · Cited by 28
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
“…International Conference (2013), P054-99. c) Julie A. Blendy, Department of Pharmacology, Perelman School of Medicine, University of Pennsylvania, 125 S. 31st Street, Philadelphia, PA 19104 U.S.A. at A SPE T Journals on A pril 23, 2022 jpet.aspetjournals.org D ow nloaded from JPET #211706 32”
BackgroundThe impact of pre-cessation varenicline on behavioral economic indices of smoking reinforcement
Schlienz, N. J., Hawk, L. W., Tiffany, S. T., O’Connor, R. J., & Mahoney, M. C. (2014) · Addictive Behaviors · doi:10.1016/j.addbeh.2014.05.008 · Cited by 29
“, 2012), and lab studies have reported a similar effect on subjective smoking satisfaction (Brandon et al., 2011; Patterson et al., 2009).”
BackgroundHypocretin mechanisms in nicotine addiction: evidence and speculation
Corrigall, W. A. (2009) · Psychopharmacology · doi:10.1007/s00213-009-1588-2 · Cited by 29
The use of varenicline to treat nicotine dependence among patients with cancer
Price, S. N., Hitsman, B. L., Veluz‐Wilkins, A. K., Blazekovic, S., Brubaker, T. R., Leone, F. T., Hole, A. V., Wileyto, E. P., Langer, C. J., Kalhan, R., et al. (2016) · Psycho-Oncology · doi:10.1002/pon.4166 · Cited by 29
“As in our past varenicline trials [9,18], a checklist and open-ended items assessed the incidence and severity of varenicline-related side effects, including potential psychiatric [18] and cardiovascular side effects.”
MethodRoh, S., Hoeppner, S. S., Schoenfeld, D., Fullerton, C. A., Stoeckel, L. E., & Evins, A. E. (2013) · Psychopharmacology · doi:10.1007/s00213-013-3286-3 · Cited by 28
“Study in acutely abstinent smokers with schizophrenia would be needed to know if varenicline may ameliorate abstinenceinduced cognitive deficits in people with schizophrenia who are trying to quit smoking as it has been shown to do in smokers without psychiatric illness (Patterson et al. 2009).”
Lotfipour, S., Mandelkern, M. A., Alvarez-Estrada, M., & Brody, A. L. (2012) · Neuropsychopharmacology · doi:10.1038/npp.2012.20 · Cited by 26
“Indeed, chronic administration of varenicline can improve mood and cognition during abstinence (Patterson et al, 2009) as well as working memory (Loughead et al, 2010), and reduce negative affect (West et al, 2008) in smokers during abstinence.”
BackgroundHartwell, K. J., LeMatty, T., McRae‐Clark, A. L., Gray, K. M., George, M. S., & Brady, K. T. (2013) · The American Journal of Drug and Alcohol Abuse · doi:10.3109/00952990.2012.750665 · Cited by 29
“During abstinence from smoking, varenicline, compared to placebo, has been shown to improve cognitive performance, including working memory and sustained attention (32).”
BackgroundKruk-Słomka, M., Budzyńska, B., & Biała, G. (2012) · Pharmacological Reports · doi:10.1016/s1734-1140(12)70904-0 · Cited by 29
Withdrawal-Related Changes in Delay Discounting Predict Short-Term Smoking Abstinence
Miglin, R., Kable, J. W., Bowers, M. E., & Ashare, R. L. (2016) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntw246 · Cited by 30
Wilkinson, D. S., & Gould, T. J. (2011) · Behavioural Brain Research · doi:10.1016/j.bbr.2011.04.010 · Cited by 26
Dissociation of tolerance and nicotine withdrawal-associated deficits in contextual fear
Gould, T. J., Wilkinson, D. S., Yildirim, E., Blendy, J. A., & Adoff, M. D. (2014) · Brain Research · doi:10.1016/j.brainres.2014.02.038 · Cited by 26
“In both mice and smokers, varenicline ameliorated cognitive withdrawal symptoms (Loughead et al., 2010; Patterson et al., 2009; Raybuck et al., 2008; Rhodes et al., 2012).”
BackgroundLiu, M., Tsai, S., Jeang, S.-Y., Peng, S.-L., Wu, S.-L., Chen, M., Tsai, Y.-L., & Yang, S.-T. (2011) · Psychiatry Research · doi:10.1016/j.psychres.2011.04.018 · Cited by 25
“Collectively, these findings have led to the suggestion that varenicline could reduce the exacerbation of symptoms caused by cigarette abstinence and increase the rate of successful cessation (Evins and Goff, 2008; Patterson et al., 2009).”
BackgroundNeural correlates of response inhibition in current and former smokers
Weywadt, C. R., Kiehl, K. A., & Claus, E. D. (2016) · Behavioural Brain Research · doi:10.1016/j.bbr.2016.11.030 · Cited by 24
Brain activity and emotional processing in smokers treated with varenicline
Loughead, J., Ray, R., Wileyto, E. P., Ruparel, K., O'Donnell, G. P., Senecal, N., Siegel, S. J., Gur, R. C., & Lerman, C. E. (2011) · Addiction Biology · doi:10.1111/j.1369-1600.2011.00324.x · Cited by 24
“This was followed by the two 13-day medication periods, based on the paradigm used in the previous human laboratory study of varenicline (Patterson et al. 2009).”
BackgroundMethodResultInfluentialSelf-citationAshare, R. L., Ray, R., Lerman, C. E., & Strasser, A. A. (2012) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2012.04.019 · Cited by 24
“…validated in healthy volunteers and patient populations (Gur et al., 2010; Kurtz et al., 2001; Ragland et al., 2002) and are sensitive to medication effects on cognition during abstinence and predict relapse (Patterson et al., 2010; 2009) (For detailed task descriptions see Patterson et al., 2009).”
BackgroundSelf-citation
Metadata
- Authors
- Patterson, F., Jepson, C., Strasser, A. A., Loughead, J., Perkins, K. A., Gur, R. C., Frey, J. M., Siegel, S., & Lerman, C.
- Affiliations
- University of Pittsburgh Medical Center (US)
- University of Pennsylvania (US)
- Abramson Cancer Center (US)
- University of Pittsburgh (US)
- AstraZeneca (United States) (US)
- Corresponding author
- Lerman, Caryn
- ORCID
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2009-01
- Volume
- 65
- Issue
- 2
- Pages
- 144-149
- ISSN
- 0006-3223 (ISSN-L)
- PMC
- PMC2615779
- OpenAlex
- W2070192651
- Semantic Scholar
- da3580cf90b2994b54327bb9684de9ef3730a592
- Cited by
- 222
- References
- 60
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 5 · 2023: 11 · 2022: 8 · 2021: 1 · 2020: 6 · 2019: 8 · 2018: 9 · 2017: 16 · 2016: 22 · 2015: 9 · 2014: 24 · 2013: 23 · 2012: 19
- FWCI
- 11.32
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Public Health Service (P5084718)
- National Cancer Institute (P50CA084718)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › 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, nicotine dependence, smoking abstinence, nicotine withdrawal symptoms, smoking urges, mood, cognition, sustained attention, working memory, α4β2 nicotinic acetylcholine receptor, smoking lapse
- MeSH terms
- Varenicline, Adult, Affect, Attention, Benzazepines, Cognition, Double-Blind Method, Female, Humans, Male, Memory, Short-Term, Middle Aged, Quinoxalines, Reaction Time, Substance Withdrawal Syndrome, Smoking Cessation, Cross-Over Studies, Nicotinic Agonists
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