Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States.
Drug Alcohol Depend. 2013 Jun 1;130(1-3):135-41. doi: 10.1016/j.drugalcdep.2012.10.021. Epub 2012 Nov 30.
The effectiveness of varenicline for smoking cessation has been established, but little is known about the psychological processes that mediate this clinical outcome.
This study evaluated the effect of a single dose of varenicline on tonic and cue-provoked changes in craving, withdrawal, and affect using a randomized, double-blind, placebo-controlled, cross-over design.
Following overnight abstinence, 38 non-treatment-motivated smokers received either varenicline 2mg or matched placebo, then tonic measures of craving, withdrawal, and positive and negative affect were obtained at 30-min intervals. At 4-h post-administration, a cue exposure session obtained the same subjective measures at three time-points following the physical handling of a lit cigarette versus the sharpening and handling of a pencil.
At 4-h post-administration, varenicline reduced tonic craving as well as craving across the smoking and neutral cue conditions, relative to placebo. By contrast, the capacity of the smoking cue to enhance craving relative to the neutral cue was unaffected by varenicline. Measures of withdrawal and positive and negative affect produced mixed results.
Acute varenicline selectively attenuates tonic but not cue-provoked craving. This dissociation provides insight into the specific psychological processes that might mediate the effectiveness of varenicline, and highlights cue-provoked craving as a discrete target for advancing smoking cessation pharmacotherapy.
已证实伐仑克林对戒烟的有效性，但对介导这一临床结果的心理过程知之甚少。
本研究采用随机、双盲、安慰剂对照、交叉设计，评估单次剂量伐仑克林对成瘾渴求、戒断和情感的静息和线索诱发变化的影响。
38 名非治疗动机的吸烟者在一夜禁酒后，接受伐仑克林 2mg 或匹配安慰剂治疗，然后以 30 分钟的间隔时间测量成瘾渴求、戒断和正性及负性情感的静息指标。给药后 4 小时，进行线索暴露，在物理处理点燃的香烟与削铅笔和处理铅笔之间的三个时间点，获得相同的主观指标。
给药后 4 小时，伐仑克林与安慰剂相比，降低了成瘾渴求的静息状态以及吸烟和中性线索条件下的成瘾渴求。相比之下，吸烟线索增强成瘾渴求的能力不受伐仑克林影响。戒断和正性及负性情感的测量结果喜忧参半。
急性伐仑克林选择性地减弱了静息但不减弱线索诱发的成瘾渴求。这种分离为阐明可能介导伐仑克林有效性的特定心理过程提供了深入了解，并突出了线索诱发的成瘾渴求作为推进戒烟药物治疗的一个离散靶点。
