Study of Varenicline (Champix) for Smoking Cessation/Reduction in Patients With Bipolar Disorder

• Status: Completed
• Trial end date: 2011-06-01
• Target enrollment: 0
• Participant gender: All

Summary

Bipolar Disorder is a chronic relapsing mental disorder characterized by periods of elevated, expansive and irritable mood, often alternating with periods of significant clinical depression. People with Bipolar Disorder are typically heavy smokers who have difficulty quitting, and this is associated with significant tobacco-related medical illness and death.

The proposed study will be a double-blind, placebo-controlled 10-week clinical trial of the safety and efficacy of varenicline (Champix™) in thirty subjects with Bipolar I Disorder. This medication is the latest first-line pharmacotherapy for smoking cessation and has been shown to be efficacious for smoking cessation, but has not yet been systematically studied in persons with Bipolar Disorder.

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Centre for Addiction and Mental Health
• Collaborators: Canadian Institutes of Health Research (CIHR); Canadian Tobacco Control Research Initiative
• Treatments: Varenicline

Criteria

Inclusion Criteria:

• Structured Clinical Interview (SCID) derived DSM-IV diagnoses of Bipolar Disorder (Type I or II), and Nicotine Dependence

• Young Mania Rating Scale Total Score <12 at study entry

• HAM-D 17-Item Score >5 and <24 at study entry

• Fagerstrom Test for Nicotine Dependence (FTND) score of 5 or higher

• Be able to provide informed consent to participate in this study as judged by clinical evaluation, and scoring at least 80% on a post-consent "test"

• Smoking at least 10 cigarettes per day (confirmed by an expired breath CO level >10 ppm and a plasma cotinine level >150 ng/ml at baseline)

• Be motivated to quit smoking within 30 days of initial evaluation, as assessed by a score of 7 or higher on the Contemplation Ladder assessment tool

• On a stable dose of a mood stabilizer for at least 1 month (e.g. lithium, valproate, carbamazepine, atypical antipsychotic)

• Judged by the study psychiatrists and/or trained psychiatric clinicians to be in remission from active manic, hypomanic, major depressive and psychotic symptoms based on a clinical interview and SCID-IV ≥1 month prior to study enrollment

Exclusion Criteria:

• Meet criteria for current abuse or dependence for any other alcohol or illicit substance within the past 3 months of study enrollment

• Current evidence by SCID-IV and clinical evaluation of suicidality, homicidality or psychosis

• Meet DSM-IV criteria for current major depression at the time of baseline evaluation

• A history of hypersensitivity or other known adverse reactions (e.g. hyperstimulation, severe agitation) to varenicline.

• Serious medical conditions (i.e. a history of severe cardiac, renal or hepatic disease, diabetes mellitus or thyroid abnormalities)

• EKG abnormalities

• Prescription of Nicotine Replacement Therapies (NRTs) including patches, gum, lozenges or inhalers

• Prescription of monoamine oxidase inhibitors (MAO-I's) including selegiline or moclobemide

• Prescription of varenicline

• Prescription of bupropion SR

• The presence of manic, mixed manic or hypomanic symptoms in the past one month prior to study enrollment.

• A lifetime history of antidepressant-induced mania or hypomania

• A history of suicidal ideation while taking antidepressants