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Record W2945050171 · doi:10.1097/cxa.0000000000000052

Effects of the Nicotinic Partial Agonist Varenicline on Smoking Lapse Behaviour in Schizophrenia

2019· article· en· W2945050171 on OpenAlexaffvenue
Karolina Kozak, Sarah S. Dermody, Maryam Sharif-Razi, Alexandria S. Coles, Marya Morozova, Victoria C. Wing, Sherry A. McKee, Tony P. George

Bibliographic record

VenueThe Canadian Journal of Addiction · 2019
Typearticle
Languageen
FieldMedicine
TopicSmoking Behavior and Cessation
Canadian institutionsUniversity of CalgaryUniversity of TorontoCentre for Addiction and Mental Health
Fundersnot available
KeywordsVareniclineSmoking cessationPartial agonistNicotineAgonistPlaceboSchizophrenia (object-oriented programming)MedicineCravingNicotinic agonistPsychologyInternal medicinePsychiatryAnesthesiaAddictionReceptor

Abstract

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ABSTRACTRésumé Background: Varenicline, a nicotinic receptor partial agonist, is a first-line smoking cessation pharmacotherapy that may reduce smoking relapse in smokers with schizophrenia (SWS). The use of human laboratory models may allow the determination of potential mechanisms to improve treatment outcomes. The first instance of smoking during a quit attempt (a “smoking lapse”) is one of the best predictors of relapse. The aim of this study was to investigate effects of varenicline on smoking lapse in SWS and controls using a validated model of smoking lapse behaviours. Methods: Varenicline was titrated up to 2 mg/d over 4 days and continued for a total of 6 days using a randomized, double-blind, placebo-controlled cross-over human laboratory lapse study design in SWS (n = 14) and nonpsychiatric control (n = 14) smokers. Results: Varenicline nonsignificantly increased time to lapse in both SWS and control groups. However, these effects were most pronounced in SWS compared to controls with higher levels of nicotine dependence (Fagerström Test for Nicotine Dependence score ≥6; Cohen's d = 0.47 SWS; d = 0.24 controls). There were no medication effects related to cognitive function, withdrawal, craving, or smoking topography outcomes. Conclusions: Our preliminary findings lack evidence in supporting the potential efficacy of varenicline on smoking relapse, particularly in SWS that may in part relate to our small sample size. Larger studies to further delineate the specific mechanisms by which varenicline ameliorates smoking relapse in SWS are needed, possibly in combination with adjunctive treatments to enhance overall relapse-prevention outcomes. Contexte: La varénicline, sevrage partiel des récepteurs nicotiniques, est une pharmacothérapie de premier plan susceptible de réduire les rechutes du tabagisme chez les fumeurs atteints de schizophrénie (SWS). L’utilisation de modèles humains en laboratoire peut permettre de déterminer les mécanismes potentiels pour améliorer les résultats du traitement. La première occurrence de tabagisme au cours d’une tentative d’arrêt du tabac (un «manque de nicotine») est l’un des meilleurs annonciateurs de rechute. Le but de cette étude était d’étudier les effets de la varénicline sur les rechutes de tabagisme chez les patients SWS et les contrôles à l’aide d’un modèle validé de comportements lors de rechute de tabagisme. Méthodes: La varénicline a été administrée jusqu’à 2 mg / jour sur 4 jours et poursuivie pendant 6 jours lors d’une étude aléatoire, ainsi qu’à double insu de contrôle placebo, en laboratoire, chez des patients atteints de schizophrénie (n = 14), ainsi que chez des sujets sous aucun contrôle psychiatrique (n = 14) fumeurs. Résultats: La varénicline a démontré un effet non-significatif dans le temps de rechute chez les sujets des deux groupes. Toutefois les effets étaient plus prononcés chez les enfants SWS que chez les témoins présentant des niveaux plus élevés de dépendance à la nicotine (score FTND > 6; d Cohen = d 0,47, schizophrénie; d = 0,24). Aucun effet médicamenteux lié aux fonctions cognitives, au sevrage, à l’état de manque ou à la topographie du tabagisme n’a été observé. Conclusions: Les résultats préliminaires n’ont démontré aucune efficacité significative de la varénicline dans la suppression des rechutes au tabagisme, surtout chez les sujets souffrants de schizophrénie. Cependant, ces résultats peuvent dépendre en partie du faible nombre de sujets. Des études plus vastes visant à définir plus précisément les mécanismes spécifiques par lesquels la varénicline améliore la rechute du tabagisme dans la schizophrénie sont nécessaires, éventuellement en association avec des traitements d’appoint pour améliorer les résultats globaux en matière de prévention des rechutes.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.012
Threshold uncertainty score0.643

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.012
GPT teacher head0.249
Teacher spread0.237 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

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Citations1
Published2019
Admission routes2
Has abstractyes

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