Varenicline effects on craving, cue reactivity, and smoking reward
Varenicline effects on craving, cue reactivity, and smoking reward
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DOI：
10.1007/s00213-011-2327-z
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发表时间：
2011-11-01
影响因子：
3.4
通讯作者：
Small, Brent J.
中科院分区：
文献类型：
--
作者：
Brandon, Thomas H.;Drobes, David J.;Small, Brent J.
Varenicline是一种α-4-β-2烟碱型乙酰胆碱受体部分激动剂，已被发现对治疗烟草依赖有效。然而，影响其疗效的主观和行为中介因素尚不清楚。目的采用多个基于实验室的评估，这项双盲、安慰剂对照实验旨在测试varenicline是否同时减少了紧张性和提示性烟草渴望，以及它是否减弱了吸烟的感知回报。方法本次分析的参与者包括100名吸烟者，他们计划进行三次评估：基线、服药前、中期、开始服药后5-7天、满剂量后12-15天。结果与安慰剂相比，Varenicline降低了对补药的渴求，减少了对补药的渴求，减少了最终评估的提示渴求，减少了吸烟所花费的时间和时间，以及对吸烟的自我报告的奖励(即，满足感)。结论结果表明，Varenicline降低了紧张素的渴望水平，并从吸烟中感受到了奖励，这与临床试验的报告一致，加强了支持这些主观作用机制的证据。这是第一项安慰剂对照研究，证明了varenicline减少了暗示引起的渴望，从而为其治疗效果提供了另一个潜在的中介。这些发现可能有助于制定更有针对性的烟草依赖干预措施。
Rationale Varenicline is an alpha 4 beta 2 nicotinic acetylcholine receptor partial agonist that has been found to be effective for treating tobacco dependence. However, the subjective and behavioral mediators of its efficacy are not known.Objectives Using multiple sessions of laboratory-based assessment, this double-blind, placebo-controlled experiment was designed to test if varenicline reduced both tonic and cue-provoked tobacco cravings, and if it attenuated perceived reward from smoking.Methods Participants in the present analysis include 100 smokers who were scheduled for three assessment sessions: at baseline, before receiving medication; at mid-run-in, 5-7 days after beginning medication; and after full dosage was reached, 12-15 days. Following overnight abstinence, each session included assessment of tonic craving, reactivity (including craving) to smoking cues, expected value of a cigarette, smoking behavior, and self-reported reward following smoking.Results Varenicline, compared to placebo, reduced tonic craving, cue-provoked craving by the final assessment, the expected value of cigarettes, number of puffs and time spent smoking, and self-reported reward (i.e., satisfaction) from smoking.Conclusions Results showing that varenicline reduced tonic craving levels and perceived reward from smoking are consistent with reports from clinical trials, strengthening the evidence in support of these subjective mechanisms of action. This is the first placebo-controlled study to demonstrate that varenicline reduced cue-provoked cravings, thereby offering another potential mediator of its therapeutic effects. Findings may aid in the development of more targeted interventions for tobacco dependence.