Varenicline decreases alcohol consumption in heavy-drinking smokersReport as inadecuate

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, Volume 223, Issue 3, pp 299–306

First Online: 01 May 2012Received: 24 October 2011Accepted: 01 April 2012


RationaleEmerging evidence suggests that the α4β2 form of the nicotinic acetylcholine receptor nAChR modulates the rewarding effects of alcohol. The nAChR α4β2 subunit partial agonist varenicline Chantix™, which is approved by the Food and Drug Administration for smoking cessation, also decreases ethanol consumption in rodents Steensland et al., Proc Natl Acad Sci U S A 104:12518–12523, 2007 and in human laboratory and open-label studies Fucito et al., Psychopharmacology Berl 215:655–663, 2011; McKee et al., Biol Psychiatry 66:185–190 2009.

ObjectivesWe present a randomized, double-blind, 16-week study in heavy-drinking smokers n = 64 randomized to treatment who were seeking treatment for their smoking. The study was designed to determine the effects of varenicline on alcohol craving and consumption. Outcome measures included number of alcoholic drinks per week, cigarettes per week, amount of alcohol craving per week, cumulative cigarettes and alcoholic drinks consumed during the treatment period, number of abstinent days, and weekly percentage of positive ethyl glucuronide and cotinine screens.

ResultsVarenicline significantly decreases alcohol consumption χ = 35.32, p < 0.0001 in smokers. Although varenicline has previously been associated with suicidality and depression, side effects were low in this study and declined over time in the varenicline treatment group.

ConclusionsVarenicline can produce a sustained decrease in alcohol consumption in individuals who also smoke. Further studies are warranted to assess varenicline efficacy in treatment-seeking alcohol abusers who do not smoke and to ascertain the relationship between varenicline effects on smoking and drinking.

KeywordsChantix Double-blind Smoking α4β2 Hazardous drinking Abuse Identifier: NCT01011907

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Author: Jennifer M. Mitchell - Candice H. Teague - Andrew S. Kayser - Selena E. Bartlett - Howard L. Fields


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