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Effects of pregabalin on smoking behavior, withdrawal symptoms, and cognitive performance in smokers

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Abstract

Rationale

In preclinical and clinical studies, medications enhancing the GABA neurotransmission attenuate nicotine reward. Pregabalin, a GABA analogue, presumably interacts with brain glutamate and GABA neurotransmission. The goal of this study was to determine pregabalin's effects on smoking behavior, nicotine withdrawal, craving for cigarettes, and cognitive performance.

Methods

Twenty-four smokers participated in an outpatient double-blind, placebo-controlled, crossover study. Subjects had a 4-day treatment period with either pregabalin (300 mg/day) or placebo and following a washout period were then crossed over for 4 days to the other treatment. In each treatment period, starting at midnight of day 1, participants were asked to stop smoking until the experimental session on day 4. During the experimental session measures of ad lib smoking behavior, tobacco withdrawal, craving for cigarettes, and cognitive performance were obtained.

Results

Pregabalin treatment, compared to placebo, did not reduce the smoking behavior during the first 3 days of treatment or during ad lib smoking period. Pregabalin treatment attenuated some tobacco withdrawal symptoms including ratings of anxious, irritable, and frustrated in abstinent smokers. Pregabalin treatment also attenuated the subjective ratings of “liking” in response to smoking. Under pregabalin treatment, smokers made more errors in a sustained attention task.

Conclusions

These findings provide limited support for pregabalin as a treatment for nicotine addiction.

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Acknowledgments

This research was supported by the Veterans Administration Mental Illness Research, Education and Clinical Center (MIRECC) and the National Institute on Drug Abuse grants R01 nnn (AIH). Dr. Sofuoglu serves as an expert witness on behalf of Pfizer in lawsuits related to varenicline.

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Authors and Affiliations

  1. School of Medicine, Department of Psychiatry and VA Connecticut Healthcare System, Yale University, 950 Campbell Ave., Bldg. 36/116A4, West Haven, CT, 06516, USA

    Aryeh I. Herman, Sherry A. McKee & Mehmet Sofuoglu

  2. Uniformed Services University of the Health Sciences, Bethesda, MD, USA

    Andrew J. Waters

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  1. Aryeh I. Herman
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  2. Andrew J. Waters
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  3. Sherry A. McKee
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  4. Mehmet Sofuoglu
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Correspondence to Mehmet Sofuoglu.

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Herman, A.I., Waters, A.J., McKee, S.A. et al. Effects of pregabalin on smoking behavior, withdrawal symptoms, and cognitive performance in smokers. Psychopharmacology 220, 611–617 (2012). https://doi.org/10.1007/s00213-011-2507-x

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  • DOI: https://doi.org/10.1007/s00213-011-2507-x

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