The findings do not mean that no such effect exists, but that this study found no strong evidence of it.
A recent clinical practice guideline on treatments for tobacco dependence in adults by the American Thoracic Society (ATS) included the use of the drug as part of the Grading of Recommendations, Assessment, Development, and Evaluation, or GRADE, approach:
- “For tobacco-dependent adults in whom treatment is being initiated, we recommend varenicline over a nicotine patch (strong recommendation, moderate certainty in the estimated effects).
- For tobacco-dependent adults in whom treatment is being initiated, we recommend varenicline over bupropion (strong recommendation, moderate certainty in the estimated effects).
- For tobacco-dependent adults in whom treatment is being initiated, we suggest varenicline plus a nicotine patch over varenicline alone (conditional recommendation, low certainty in the estimated effects).
- For tobacco-dependent adults in whom treatment is being initiated, we suggest varenicline over electronic cigarettes (conditional recommendation, very low certainty in the estimated effects).
- In tobacco-dependent adults who are not ready to discontinue tobacco use, we recommend that clinicians begin treatment with varenicline rather than waiting until they are ready to stop tobacco use (strong recommendation, moderate certainty in estimated effects).
- For tobacco-dependent adults with co-morbid psychiatric conditions, including substance use disorder, depression, anxiety, schizophrenia and/or bipolar disorder, for whom treatment is being initiated, we recommend varenicline over a nicotine patch (strong recommendation, moderate certainty in estimated effects).
- For tobacco-dependent adults for whom treatment is being initiated with a controller, we recommend using extended duration (greater than 12 weeks) over standard duration (6-12 weeks) (strong recommendation, moderate certainty in estimated effects).”
Is it safe or not?
Such recommendations have always been met with criticism as many Varencilline users report suffering from disturbing dreams and a number of psychiatric disorders. To this effect, the study titled, “Estimation of risk of neuropsychiatric adverse events from varenicline, bupropion and nicotine patch versus placebo: secondary analysis of results from the EAGLES trial using Bayes factors,” conducted a trial to document the experience of 8144 smokers who were currently on the medication.
The research failed to identify a ‘statistically significant’ difference between the rate of psychiatric adverse events in people given varenicline and those given an inactive placebo. This of course does not mean that no such effect exists, but that this study found no strong evidence of it.
Lead study author Dr. Emma Beard (UCL Behavioural Science and Health), who led the analysis, said that the bad reputation of the drug has been putting many lives at risk. “The shadow of psychiatric problems has arguably cost thousands of lives by putting people off using Varenicline to help them stop, and doctors off prescribing it. This analysis should provide further reassurance to smokers and clinicians that this is a safe, life-saving drug.”
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