Effects of Short-Term Varenicline Administration on Emotional and Cognitive Processing in Healthy, Non-Smoking Adults: A Randomized, Double-Blind, Study

• Published in: Neuropsychopharmacology (New York, N.Y.) Vol. 38; no. 3; pp. 476 - 484
• Main Authors: MOCKING, Roel Jt, PFLANZ, C. Patrick, PRINGLE, Abbie, PARSONS, Elizabeth, MCTAVISH, Sarah F, COWEN, Phil J, HARMER, Catherine J
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 01.02.2013
• Subjects: Addictions; Addictive behaviors; Adolescent; Adult; Adult and adolescent clinical studies; Benzazepines - administration & dosage; Biological and medical sciences; Biomarkers; Cognition - drug effects; Cognition - physiology; Cognitive ability; Depression; Desintoxication. Drug withdrawal; Double-Blind Method; Drug addiction; Drugs; Emotions; Emotions - drug effects; Emotions - physiology; Female; Health Status; Humans; impulsive behavior; Impulsivity; Information processing; Male; Medical sciences; Memory; Mental depression; Mood; Mood disorders; Neurosciences; Nicotine; Nicotinic Agonists - administration & dosage; Original; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Quinoxalines - administration & dosage; Reaction Time - drug effects; Reaction Time - physiology; Smoking; Smoking cessation; Startle response; Suicidal behavior; Suicides & suicide attempts; Surveys and Questionnaires; Time Factors; Tobacco smoking; Tobacco, tobacco smoking; Toxicology; Treatment Outcome; Treatments; Varenicline; Young Adult; United Kingdom > UK; Short term; Partial agonist; Toxicity; Varenicline; Tobacco smoking; Cholinergic receptor; Randomization; adverse effects: depression; Disintoxication; Adult; Nicotinic receptor; Human; Mood disorder; Poison withdrawal; Healthy subject; Controlled therapeutic trial; Depression; Emotion emotionality; randomized controlled trial; Tobacco; smoking cessation; Information processing; Double blind study; nicotinic agonists; tobacco use cessation products
• ISSN: 0893-133X; 1740-634X
• DOI: 10.1038/npp.2012.205

Varenicline is an effective and increasingly prescribed drug for smoking cessation, but has been associated with depressive symptoms and suicidal behavior. However, it remains unclear whether those changes in mood and behavior are directly related to varenicline use, or caused by smoking cessation itself or reflects depression and suicidality rates in smokers, independent of treatment. To investigate the influence of varenicline on mood and behavior independent of smoking and smoking cessation, we assessed the effects of varenicline on emotional processing (a biomarker of depressogenic effects), emotion-potentiated startle reactivity, impulsivity (linked with suicidal behavior), and cognitive performance in non-smoking subjects. We used a randomized, double-blind design, in which we administered varenicline or placebo to healthy subjects over 7 days (0.5 mg/day first 3 days, then 1 mg/day). Cognitive and emotional processing was assessed by a battery of computerized tasks and recording of emotion-potentiated startle response. A total of 41 subjects were randomized, with 38 subjects included in the analysis. The varenicline group did not differ from placebo in terms of negative biases in emotional processing or mood. However, compared with placebo, the varenicline group scored higher on working and declarative memory. In conclusion, short-term varenicline use did not influence negative biases in emotional processing or impulsivity in non-smoking subjects, thereby not supporting direct depressogenic or suicidal risk behavior-inducing effects. In contrast, varenicline may have cognitive-enhancing effects.