NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update

PostScript 79 (Jan 2014) Smoking Cessation: varenicline and depression

Smoking cessation

Smoking cessation with or without pharmacotherapy has been associated with exacerbations of underlying psychiatric illness, eg depression, anxiety. The Smokefree smoking cessation service has received several enquiries about varenicline being prescribed to patients with a history of depression or currently being prescribed an antidepressant.  Although a history of depression or active treatment with an antidepressant is not a contra-indication for varenicline use; varenicline should be used with caution in these circumstances.


The BNF advises, as per MHRA advice, that patients should discontinue treatment with varenicline and seek prompt medical advice if they develop agitation, depressed mood or suicidal thoughts and those with a history of psychiatric illness should be monitored while taking varenicline. 


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