Suicidal thoughts and behaviour have been reported in users of Varenicline who have no known pre-existing psychiatric conditions, and while they continue to smoke. Anyone taking varenicline who develops depression or suicidal thoughts should stop, their treatment and contact their doctor immediately.
Tobacco: harm-reduction approaches to smoking – more information can be found at:http://www.nice.org.uk/nicemedia/live/14178/63996/63996.pdf
NICE: Issued: June 2013
Patients should be told to stop treatment and contact their doctor immediately if they develop suicidal thoughts or
behaviour. Varenicline should be stopped immediately if agitation, depressed mood, or changes in behaviour are observed that are of concern to the patient, family or caregivers. The safety and efficiacy of Varenicline in people with serious psychiatric illness have not been established. Patients who have a history of psychiatric illness should be monitored closely while taking varenicline.
MHRA Drug Safety Update July 2008
The National Institute for Health and Clinical Excellence has issued guidance on the use of varenicline for smoking cessation. The recommendations are:* Varenicline, within its licensed indications, is recommended as an option for smokers who have expressed a desire to quit smoking
Varenicline should normally be prescribed only as part of a programme of behavioural support.
Varenicline for smoking cessation NICE TA123 July 2007
When choosing a smoking cessation aid, prescribers should take into account the adverse event profile and relative cost of each agent. With these factors in mind, Varenicline may by an alternative to bupropion where NRT is contraindicated or not tolerated. Varenicline is not recommended for use in children or adolescents <18 years of age. Ref: Regional Drug and Therapeutics Centre