Neuropsychiatric events in varenicline and nicotine replacement patch users in the Military Health System
Article first published online: 18 OCT 2012
Published 2012. This article is a U.S. Government work and is in the public domain in the USA.
Volume 108, Issue 1, pages 203–210, January 2013
How to Cite
Meyer, T. E., Taylor, L. G., Xie, S., Graham, D. J., Mosholder, A. D., Williams, J. R., Moeny, D., Ouellet-Hellstrom, R. P. and Coster, T. S. (2013), Neuropsychiatric events in varenicline and nicotine replacement patch users in the Military Health System. Addiction, 108: 203–210. doi: 10.1111/j.1360-0443.2012.04024.x
- Issue published online: 26 DEC 2012
- Article first published online: 18 OCT 2012
- Accepted manuscript online: 19 JUL 2012 01:13PM EST
- Manuscript Accepted: 12 JUL 2012
- Manuscript Revised: 28 MAR 2012
- Manuscript Received: 20 JAN 2012
- Claims analysis;
- cohort studies;
- nicotine patch;
- nicotine replacement products;
- propensity score;
- psychiatric diagnosis;
- survival rate;
- tobacco use cessation products;
To determine the rate ratio of neuropsychiatric hospitalizations in new users of varenicline compared to new users of nicotine replacement therapy (NRT) patch in the Military Health System (MHS).
Design, setting and participants
Varenicline (n = 19 933) and NRT patch (n = 15 867) users who initiated therapy from 1 August 2006 to 31 August 2007 within the MHS were included in this retrospective cohort study. After matching according to propensity scores, 10 814 users remained in each cohort. The study population included those with and without a history of neuropsychiatric disease.
Patients were followed for neuropsychiatric hospitalizations defined by primary neuropsychiatric discharge diagnosis using ICD-9 codes from in-patient administrative claims. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated after propensity score matching on exposure for socio-demographic factors, health-care utilization, comorbidities, medication history and neuropsychiatric history.
There was no increase in the rate of neuropsychiatric hospitalizations in patients treated with varenicline compared to NRT patch when followed for 30 days (propensity-score matched HR = 1.14, 95% CI: 0.56–2.34). Results were similar after 60 days of follow-up.
There does not appear to be an increase in neuropsychiatric hospitalizations with varenicline compared with nicotine replacement therapy patch over 30 or 60 days after drug initiation.