T. Kishi and N. Iwata: Varenicline for smoking cessation in people with schizophrenia: systematic review meta-analysis

  • A. Eden EvinsEmail author
  • L. Elliot Hong
  • Deanna L. Kelly
Letter to the Editor

Dear Prof. Dr. Falkai,

The meta-analysis of efficacy of varenicline for smoking cessation in schizophrenia by Kishi and Iwata published in European Archives of Psychiatry and Clinical Neuroscience inappropriately included two trials which were not smoking cessation trials, conducted in patients with schizophrenia with no intention to quit smoking, which caused the authors to erroneously conclude that varenicline is ineffective for smoking cessation in this important population of smokers [1]. The meta-analysis appropriately included the two randomized, controlled smoking cessation trials in smokers with schizophrenia that demonstrate efficacy for varenicline when added to behavioral smoking cessation support in this population at the end of the treatment [2, 3], but inappropriately included two randomized, controlled trials of varenicline as a putative cognitive enhancing agent in smokers and non-smokers with schizophrenia, who expressed no desire to quit smoking prior to enrollment,...


Schizophrenia Smoking Cessation Psychotic Disorder Varenicline Smoking Cessation Treatment 
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Dr. Evins is supported by NIH Grants R01 DA021245 Smoking Cessation and Smoking Relapse Prevention in Patients with Schizophrenia and K24 DA030443 Mentoring in Addiction Treatment Research.

Conflict of interest

Dr. Evins reports receiving study product and unrestricted research funding support to her institution from EnVivo Pharmaceuticals, GSK and Pfizer. Pfizer is the manufacturer of varenicline. Dr. Hong has received unrestricted research funding from Mitsubishi, Your Energy Systems LLC, and Pfizer. Pfizer is the manufacturer of varenicline. Dr. Kelly reports no potential conflicts.


  1. 1.
    Kishi T, Iwata N (2014) Varenicline for smoking cessation in people with schizophrenia: systematic review and meta-analysis. Eur Arch Psychiatry Clin Neurosci. doi: 10.1007/s00406-014-0551-3
  2. 2.
    Williams JM, Anthenelli RM, Morris CD, Treadow J, Thompson JR, Yunis C, George TP (2012) A randomized, double-blind, placebo-controlled study evaluating the safety and efficacy of varenicline for smoking cessation in patients with schizophrenia or schizoaffective disorder. J Clin Psychiatry 73(5):654–660CrossRefPubMedGoogle Scholar
  3. 3.
    Weiner E, Buchholz A, Coffay A, Liu F, McMahon RP, Buchanan RW, Kelly DL (2011) Varenicline for smoking cessation in people with schizophrenia: a double blind randomized pilot study. Schizophr Res 129(1):94–95CrossRefPubMedCentralPubMedGoogle Scholar
  4. 4.
    Shim JC, Jung DU, Jung SS, Seo YS, Cho DM, Lee JH, Lee SW, Kong BG, Kang JW, Oh MK, Kim SD, McMahon RP, Kelly DL (2012) Adjunctive varenicline treatment with antipsychotic medications for cognitive impairments in people with schizophrenia: a randomized double-blind placebo-controlled trial. Neuropsychopharmacology 37(3):660–668CrossRefPubMedCentralPubMedGoogle Scholar
  5. 5.
    Hong LE, Thaker GK, McMahon RP, Summerfelt A, Rachbeisel J, Fuller RL, Wonodi I, Buchanan RW, Myers C, Heishman SJ, Yang J, Nye A (2011) Effects of moderate-dose treatment with varenicline on neurobiological and cognitive biomarkers in smokers and nonsmokers with schizophrenia or schizoaffective disorder. Arch Gen Psychiatry 68:1195CrossRefPubMedCentralPubMedGoogle Scholar
  6. 6.
    Evins AE, Cather C, Pratt SA, Pachas GN, Hoeppner SS, Goff DC, Achtyes ED, Ayer D, Schoenfeld DA (2014) Maintenance treatment with varenicline for smoking cessation in patients with schizophrenia and bipolar disorder: a randomized clinical trial. JAMA 311(2):145–154CrossRefPubMedCentralPubMedGoogle Scholar
  7. 7.
    Huang Y, Lewis S, Britton J (2014) Use of varenicline for smoking cessation treatment in UK primary care: an association rule mining analysis. BMC Public Health 14(1):1024CrossRefPubMedCentralPubMedGoogle Scholar
  8. 8.
    Callaghan RC, Veldhuizen S, Jeysingh T, Orlan C, Graham C, Kakouris G, Remington G, Gatley J (2014) Patterns of tobacco-related mortality among individuals diagnosed with schizophrenia, bipolar disorder, or depression. J Psychiatr Res 48(1):102–110CrossRefPubMedGoogle Scholar
  9. 9.
    Tsoi DT, Porwal M, Webster AC (2013) Interventions for smoking cessation and reduction in individuals with schizophrenia. Cochrane Database Syst Rev 2:CD007253PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • A. Eden Evins
    • 1
    Email author
  • L. Elliot Hong
    • 2
  • Deanna L. Kelly
    • 2
  1. 1.Massachusetts General Hospital and Harvard Medical SchoolBostonUSA
  2. 2.University of Maryland School of MedicineBaltimoreUSA

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