Medicine helps patients with mental illness stop smoking

The medication varenicline may be of particular advantage in helping patients with mental illness to stop smoking, researchers have found. According to background information supplied by the researchers, varenicline reduces symptoms of withdrawal and also reduces the reinforcement received from nicotine while smoking. Against that background, a total of 22 patients were randomly assigned to receive either varenicline or placebo for three weeks. The patients underwent functional magnetic timbre imaging scans before and after the treatment period, during which they viewed short video-clips, which included scenes that involved smoking and scenes that did not. In scans performed before treatment, the viewing of smoking cues activated brain areas known as the ventral striatum and medial orbitofrontal cortex and also elicited reports of cravings, whereas the viewing of impartial cues did not.

After the treatment period, similar patterns persisted in patients who had taken placebo, whereas those treated with varenicline experienced a decrease in both brain activity and reported cravings in response to smoking cues. In a scan taken while the individuals were at rest before viewing the videos, participants who took varenicline showed a greater activation in the brain area known as tangential orbitofrontal cortex than did those who took placebo. Increased activation in this area predicted a blunted response in the medial orbitofrontal cortex when the smoking cues were shown. “The results of our study reveal a distinctive new action of varenicline that may contribute to its clinical efficacy,” the authors concluded. “Unsuccessful smoking cessation is more widespread in individuals with psychiatric illness, suggesting that they have greater difficulty quitting.