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Depression is associated with elevated rates of smoking, new nicotine dependence, and relapse after smoking cessation. Varenicline has produced greater quit rates than bupropion in some studies of nondepressed smokers, but reports of greater depression and suicidal ideation with this medication have limited its use with depressed patients. In a 12-month, randomized, controlled, manufacturer-funded study, researchers examined the efficacy and safety of 12 weeks of varenicline (0.5–1.0 mg twice daily) and placebo in 525 smokers with recent unipolar depression. Mean depression scores were low, but some patients remained symptomatic; overall, more than 70% of participants were receiving antidepressants.
The rate of smoking cessation was double w…