Via practica 6/2017

The most common cause of death of psychiatric patients: We should not be afraid to treat it

Smoking related diseases are the leading cause of death among psychiatric patients. Effective treatment for tobacco dependence exists: it involves both interventions aimed at changing smoking stereotypes and search for nonsmoking solutions in combination with pharmacotherapy. First-line drugs are nicotine replacement therapy, bupropion and varenicline, currently the most effective one. Among psychiatric patients, so far the fear of neuropsychiatric side effects prevented broader application of varenicline. However, they have now been definitively refuted EAGLES large study that involved more than 8,000 smokers, of whom over 4,000 with psychiatric diagnosis. The European Medicines Association on that basis decided to eliminate this warning from the package insert. Moreover, benefits of abstinence from smoking for prognosis and treatment of psychiatric disorders are repeatedly proven. Failure to provide evidence-based tobacco dependence treatment to psychiatric patients can now hardly be excused.

Keywords: smoking, tobacco dependence, psychiatric patient, treatment, varenicline, bupropione, neuropsychiatric adverse effects