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- 2012
- January (11)
- PFC Lowers Antibodies!
- People Don't Stop Smoking After Seing Plaque in Carotids!
- Pharmaceutical Companies and Physicians
- Importance of Vitamin D
- Statin Drugs and Diabetes
- Heart Attacks and Long Distance Running
- Wasted Research Money?
- Nicotine Patch Ineffective
- So How Much Exercise Can You Squeeze In?
- Neti-Pot Problems
- AHA Study: Heart Disease Increasing
- 2011
- December (11)
- Cranberries vs. Antibiotics for UTI
- Antioxidants Reduce Cancer Risk
- Back Surgery: Too Many, Too Costly, Too Ineffective!
- Simvastin (Zocor, Vytorin, Simcor) Danger
- Physicians Rate Insurance Companies
- Anti-coagulant Drug Problems
- Bad News about Stop Smoking Drug
- Antibiotics: Inappropriately Used
- Exercise More Important Than BMI
- Pediatric Antibiotis: Over Prescribed?
- FDA Criticized Dr. Oz But Was It Fair?
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More Bad News About Varenicline
Compared with other smoking-cessation treatments, the risk for suicidal behavior or depression was markedly increased with varenicline.
The safety of varenicline for smoking cessation continues to generate controversy. In a recent systematic review and meta-analysis,
investigators analyzed data from 14 trials and found a significantly increased risk for cardiovascular events with varenicline. Now, a group that includes some of the same authors has evaluated data from the FDA's Adverse Event Reporting System (AERS) to compare the neuropsychiatric safety profiles of three smoking-cessation treatments: varenicline, bupropion, and nicotine-replacement products.
The AERS consists of case reports about serious adverse events that are sent to drug manufacturers or directly to the FDA. From 13,243 case reports on the three products, the investigators identified 3249 events described as suicidal/self-injurious behavior or depression. Of these events, 90% were associated with varenicline, 7% with bupropion, and 3% with nicotine replacement. Of the 295 completed suicides, 92% were associated with varenicline. Headache and pain events, which are not surmised to be associated with these drugs but are common symptoms of nicotine withdrawal, did not differ in prevalence among the three interventions.
Comment: This study has many limitations and provides no information on absolute risk, but the findings raise further concerns about the adverse-event profile of varenicline. The challenge for clinicians is to balance these potential risks against the clear benefits of smoking cessation. These authors conclude that varenicline should not be used as a first-line agent for smoking cessation. Until more information on adverse-event incidence is available, the drug should at least be prescribed with caution and close surveillance. As you probably no, I am not a big fan of taking drugs to stop smoking, dieting, or eliminating any bad habits. The only way to truly change is to change your mind and concentrate on health. When you do that, the idea of eating poor artery clogging foods or inhaling chemicals is repulsive.