Neuropsychiatric disturbance after initiation of varenicline in a patient with a history of alcohol abuse and major depression

American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
Pejman PirmoradiSofia S Nadeem

Abstract

The case of a patient with a history of alcohol abuse and major depression who developed neuropsychiatric symptoms after initiation of varenicline is reported. A 33-year-old Caucasian man was prescribed varenicline for smoking cessation. He had a history of hypertension, alcohol dependency, major depression, and hypothyroidism. The patient's only reported allergy was to morphine. The patient reported smoking four or five cigarettes daily for 10 years and discontinued alcohol use 2 years before varenicline initiation. He was prescribed varenicline 0.5 mg once daily; after three days, the dosage was increased to 0.5 mg twice daily, based on recommendations in the package insert. On the evening of the seventh day, after taking 10 doses of varenicline, the patient developed severe anxiety, nausea, vertigo, blurred vision, and dizziness. He reported to his physician's office where his blood pressure was 120/75 mm Hg and his heart rate was approximately 70 beats/min. His laboratory test results were unremarkable for liver and kidney dysfunction. Since the only recent change to his drug therapy was the initiation of varenicline, the drug was discontinued, after which his symptoms subsided gradually and completely disappeared after thr...Continue Reading

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Citations

Feb 25, 2009·Journal of General Internal Medicine·Jennifer B McClureHarold Javitz
Jan 2, 2013·Journal of Clinical Psychopharmacology·Amir I A AhmedWillem M A Verhoeven
Feb 15, 2012·Cognitive and Behavioral Neurology : Official Journal of the Society for Behavioral and Cognitive Neurology·Daniel TranelAntoine Bechara
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Jun 15, 2010·Journal of the American Academy of Dermatology·Matilda W NicholasDean S Morrell
Apr 7, 2010·Journal of Substance Abuse Treatment·Jennifer B McClureSusan M Zbikowski
Jun 30, 2009·Pharmacotherapy·Bethany A DiPaula, Michele D Thomas
Feb 3, 2015·Progress in Neuro-psychopharmacology & Biological Psychiatry·Iren CsalaJudit Lazary
Aug 7, 2014·The Annals of Pharmacotherapy·Beth L Erwin, Rachel M Slaton

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