Varenicline plus healthy lifestyle intervention for smoking cessation in psychotic disorders

BACKGROUND: We were interested in exploring the efficacy and safety of varenicline as an adjunct to a healthy lifestyle intervention for smoking cessation among individuals with a severe mental illness. Methods: We used varenicline as an adjunct to a healthy lifestyle intervention in 14 smokers with a psychotic illness. Results: Overall, smoking cessation rates were 36% at 3 months and 42% at 6 months. The most commonly reported side effects were sleep disturbance and nausea. These tended to occur early in treatment, and patients responded to general measures of support and reassurance. Of the 14 participants, 1 dropped out because of psychiatric problems and 2 because of other side effects. Conclusions: Varenicline appears to be an effective adjunct to a healthy lifestyle intervention for smokers with a psychotic illness. Although the results of this open study are encouraging, replication in an adequately powered, randomized controlled trial is required before definitive conclusions can be drawn.