Anxiety disorder raises risk for some neuropsychiatric AEs during smoking cessation

  • Ayers CR & al.
  • Depress Anxiety
  • 18.12.2019

  • von Kelli Whitlock Burton
  • Clinical Essentials
Der Zugang zum gesamten Inhalt dieser Seite ist nur Angehörigen medizinischer Fachkreise vorbehalten. Der Zugang zum gesamten Inhalt dieser Seite ist nur Angehörigen medizinischer Fachkreise vorbehalten.

Takeaway

  • People with anxiety disorders (ADs) had a higher risk for neuropsychiatric adverse events (NPSAEs) during attempts to quit smoking than people without mental illness, regardless of smoking cessation treatment, and had lower continuous smoking abstinence rates.

Why this matters

  • Varenicline was the most effective cessation treatment for people with generalized anxiety disorder (GAD) and panic disorder (PD), and nicotine replacement therapy (NRT) was most effective in patients with PD.

Study design

  • Smokers with AD (posttraumatic stress disorder [PTSD], n=192; GAD, n=243; PD, n=277) and a nonpsychiatric cohort (NPC; n=4028) were included in this post hoc subgroup analysis of the EAGLES trial.
  • Funding: Pfizer; GlaxoSmithKline.

Key results

  • Incidence of NPSAEs was higher in PTSD (6.9%), GAD (5.4%), and PD (6.2%) vs NPC (2.1%; comparative P<.0001>
  • Continuous abstinence rates weeks 9-12 (CAR9-12) in smokers vs NPC:
    • PTSD: OR, 0.58 (95% CI, 0.33-1.01).
    • GAD: OR, 0.72 (95% CI, 0.45-1.16).
    • PD: OR, 0.53 (95% CI, 0.31-0.88).
  • No significant difference in CAR9-12 was noted among smokers with PTSD.
  • Varenicline vs placebo showed superior efficacy in GAD (OR, 4.53) and PD (OR, 8.49).
  • NRT significantly improved quit rates in PD (OR, 7.42).

Limitations

  • Limited generalizability of findings.

Coauthored with Chitra Ravi, MPharm