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Treatment options for patients who smoke and want to quit include nicotine replacement, bupropion, and varenicline. However, some people are concerned that bupropion and varenicline might increase risks for depression and self-harm. In a previous (flawed) study, patients who were prescribed nicotine replacement, bupropion, or varenicline had similar risks for self-harm and suicide (NEJM JW Gen Med Oct 27 2009). In this prospective cohort study, the same U.K. research group used large primary care and national mortality databases to compare risks for depression, self-harm, and suicide in adult patients prescribed bupropion or varenicline with those in patients prescribed nicotine replacement.
Overall, 120,000 patients who received smoking-ces…