Main Category: Neurology / Neuroscience
Also Included In: Smoking / Quit Smoking
Article Date: 24 Feb 2012 – 1:00 PST

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A nicotinic drug approved for smoking cessation significantly improved the walking ability of patients suffering from an inherited form of ataxia, reports a new clinical study led by University of South Florida researchers.

The randomized controlled clinical trial investigated the effectiveness of varenicline (Chantix®) in treating spinocerebellar ataxia type 3, or SCA3. The findings were published online earlier this month in Neurology, the journal of the American Academy of Neuroscience.

Lead author Dr. Theresa Zesiewicz and colleagues at the USF Ataxia Research Center collaborated with researchers from Beth Israel Deaconess Medical Center in Boston, MA, and from the David Geffen School of Medicine at UCLA in Los Angeles, CA.

Spinocerebellar ataxia impairs the brain and spinal cord causing progressive difficulty with coordination of movements, including walking. The uncoordinated movements, or ataxia, is a neurological symptom with no treatment or cure and can lead to serious fall-related injuries.

“This is the first clinical trial in patients with ataxia showing that nicotinic acetycholine agonists improve symptoms associated with the ability to stand straight and walk,” said Dr. Zesiewicz, professor of neurology and director of the USF Ataxia Research Center. “Patients receiving varenicline could walk with more ease, with less help and faster than those in the placebo group.”

The double-blind multicenter study evaluated 20 adult patients with genetically confirmed SCA3. Half the patients received 1 mg. of varenicline twice a day, and the other half received placebo. At the end of the eight-week study, patients taking varenecline performed significantly better on measures of gait, stance, rapid alternating movements and a timed 25-foot walk than those who did not. The drug was fairly well tolerated, with mild nausea being the most common side effect.

The study authors suggest that varenicline’s ability to improve ataxia may be associated with the drug’s ability to act at several different sites in the brain affected by nicotine.

Study co-author Lynn Wecker, PhD, a distinguished research professor at USF Health, is investigating the cellular and molecular mechanisms mediating the effects of varenicline and other nicotinic agonists. Dr. Wecker and colleagues, supported by a five-year grant funded by the National Institute of Neurological Disorders and Stroke, have shown that several drugs affecting neuronal nicotinic receptors improve gait and balance in an animal model of SCA3.

Further preclinical research is needed to understand how nicotinic acetylcholine agonists improve ataxia, and larger clinical studies with more patients are needed to identify other neurodegenerative diseases that may benefit from nicotinic medications, the authors conclude.

Article adapted by Medical News Today from original press release. Click ‘references’ tab above for source.
Visit our neurology / neuroscience section for the latest news on this subject. The study was supported by the National Ataxia Foundation and the Bobby Allison Ataxia Research Center.
Citation: “A randomized trial of varenicline (Chantix) for the treatment of spinocerebellar ataxia type 3,”T.A. Zesiewicz, MD, FAAN; P.E. Greenstein, MB, BCh; K.L. Sullivan, MSPH; L. Wecker, PhD; A. Miller, BS; I. Jahan, MD; R. Chen, MD and S.L. Perlman, MD, FAAN, Neurology, published online before print Feb. 8, 2012. DOI: 10.1212/WNL.0b013e318247cc7a.
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University of South Florida (USF Health). “In Patients With Spinocerebellar Ataxia Type 3, Smoking Cessation Drug Improves Walking Function.” Medical News Today. MediLexicon, Intl., 24 Feb. 2012. Web.
26 Feb. 2012. APA

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HomeNewsA Late Happy New Year! May Smoking Cessation be your Resolution

February 15, 2012   I am physician and much of what we do is smoking related disease.  Treatment of emphysema and the diagnosis of lung cancer is a regular occurrence. In the 10 days before New Year’s Day I diagnosed lung cancer three separate times—all were incurable at the time of discovery—and on Christmas Eve we could do nothing to stop a woman from dying because of unrelenting bleeding in her windpipe, possibly an undiscovered tumor, bleeding into her lungs—may be it was tuberculosis but that is less prevalent and less likely.  So, I hope you can see why this season, more than ever, I am troubled by the multiple and overwhelming costs of the addiction to tobacco products.  So let me ramble a bit today about disease, cost, politics, and smoking cessation efforts. 

For More Information:
http://www.dailykos.com/story/2012/02/12/1064005/-A-Late-Happy-New-Year-May-Smoking-Cessation-be-your-Resolution

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Main Category: Alcohol / Addiction / Illegal Drugs
Also Included In: Smoking / Quit Smoking
Article Date: 16 Feb 2012 – 2:00 PST

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Varenicline is an effective smoking-cessation medication that may also reduce drinking. However, the means by which it might reduce drinking is unclear. A study of the effects of varenicline on subjective, physiological, and objective responses to low and moderate doses of alcohol among healthy social drinkers has found that varenicline may reduce drinking by increasing alcohol’s aversive effects.

Results will be published in the May 2012 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

“Varenicline was first approved in the USA for treatment of nicotine dependence in 2006,” said Emma Childs, research associate at the University of Chicago as well as corresponding author for the study. “Smokers who use varenicline are approximately two to three times more likely to remain abstinent six months or more after their quit date. After it was approved, several patients treated with varenicline also reported reductions in their drinking, so investigators began to assess if this was an actual effect and how it might be produced.”

“Since there is a high comorbidity between nicotine and alcohol dependence, a single medication that could decrease the use of both substances would be ideal,” added Hugh Myrick, associate professor of psychiatry as well as vice chair of the Psychiatry Practice Plan at the Medical University of South Carolina.

Childs and her colleagues assessed 15 healthy participants (8 males, 7 females) during six randomized sessions: three sessions each with 2 mg varenicline and placebo, followed three hours later by a beverage containing placebo, a low dose of alcohol (0.4g/kg), or a high dose of alcohol (0.8g/kg). Measures included subjective mood and drug effects such as stimulation and drug liking, physiological measures such as heart rate and blood pressure, and the results of eye-tracking tasks before and after drug and alcohol administration.

“We found that varenicline increased the unpleasant effects of alcohol and decreased drug liking,” said Childs, “thus we think that varenicline may reduce drinking by altering the effects of alcohol.”

“There are generally two ways that a medication may help reduce alcohol use,” observed Myrick. “First, the rewarding aspects of alcohol could be reduced. An example of a medication that works by reducing reward is naltrexone, which blocks opiate receptors and therefore reduces the rewarding aspects of dopamine in the ventral striatum. Second, the aversive aspects of alcohol could be increased. In other words, the medication would cause symptoms leading to a decrease in alcohol use. Disulfiram, or Antabuse, is a medication that works by causing aversive effects if alcohol is consumed. Varenicline may work in a similar fashion.”

“Our findings shed light on the mechanism underlying why people consume less alcohol when they have taken varenicline,” said Childs. “The pleasurable effects of alcohol, for example feeling ‘buzzed’ and talkative, are associated with greater consumption and binge drinking. Some people lose control of their alcohol consumption during a drinking episode, for example they may aim to only have one or two drinks but end up drinking say four or five. If varenicline counteracts these positive effects by producing unpleasant effects, then as a result people may consume less alcohol during a drinking episode.”

“Varenicline may find a nice niche in those individuals who are both nicotine and alcohol dependent,” noted Myrick, “who we know represent a large portion of alcohol-dependent individuals.”

Article adapted by Medical News Today from original press release. Click ‘references’ tab above for source.
Visit our alcohol / addiction / illegal drugs section for the latest news on this subject. The University of Chicago
Medical University of South Carolina
Alcoholism: Clinical & Experimental Research Please use one of the following formats to cite this article in your essay, paper or report:

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Alcoholism: Clinical & Experimental Research. “Varenicline For Smoking Cessation Also Makes Drinking Less Enjoyable.” Medical News Today. MediLexicon, Intl., 16 Feb. 2012. Web.
19 Feb. 2012. APA

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View the original article here