Varenicline decreases alcohol consumption in heavy-drinking smokers

• Published in: Psychopharmacologia Vol. 223; no. 3; pp. 299 - 306
• Main Authors: Mitchell, Jennifer M., Teague, Candice H., Kayser, Andrew S., Bartlett, Selena E., Fields, Howard L.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.10.2012; Springer; Springer Nature B.V
• Subjects: Acetylcholine receptors (nicotinic); Addictive behaviors; Adult; Adult and adolescent clinical studies; Alcohol Drinking - prevention & control; Alcohol Drinking - psychology; Alcohol use; Alcoholic beverages; Alcoholics; Alcoholism - prevention & control; Alcoholism - psychology; Behavior modification; Benzazepines - administration & dosage; Benzazepines - adverse effects; Benzazepines - pharmacology; Benzazepines - therapeutic use; Beverages; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Cigarettes; Cotinine; Depression; Double-Blind Method; Drinking behavior; Drinking of alcoholic beverages; Drug abuse; Drug addiction; Drug Administration Schedule; Drug approval; Ethanol; Female; Health Records, Personal; Humans; Male; Medical sciences; Middle Aged; Neurosciences; Nicotinic Agonists - administration & dosage; Nicotinic Agonists - adverse effects; Nicotinic Agonists - pharmacology; Nicotinic Agonists - therapeutic use; Original Investigation; Pharmacology/Toxicology; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychopharmacology; Quinoxalines - administration & dosage; Quinoxalines - adverse effects; Quinoxalines - pharmacology; Quinoxalines - therapeutic use; Reinforcement; Side effects; Smoke; Smokers; Smoking; Smoking - drug therapy; Smoking - psychology; Smoking cessation; Smoking Cessation - methods; Smoking Cessation - psychology; Smoking cessation programs; Tobacco smoking; Tobacco, tobacco smoking; Toxicology; Treatment Outcome; Varenicline; Young Adult; Hazardous drinking; Double-blind; Abuse; Chantix; α4β2; Smoking; Consumption; Partial agonist; Toxicity; Varenicline; Tobacco smoking; Drinking; Substance abuse; Alcoholic beverage; Cholinergic receptor; Smoker; Double blind study; Nicotinic receptor
• ISSN: 0033-3158; 1432-2072
• DOI: 10.1007/s00213-012-2717-x

Rationale Emerging 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 ). Objectives We 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. Results Varenicline significantly decreases alcohol consumption ( χ 2  = 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. Conclusions Varenicline 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.