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Smoking cessation with varenicline: a suicidal fatality
Pascal Kintz1, Julie Evans, Marion Villain
1Laboratoire ChemTox, 3 rue Gruninger, 67400 Illkirch, France. pascal.kintz@wanadoo.fr
This case study details a suicide in a 39-year-old man prescribed varenicline for smoking cessation. A blood analysis detected 10 ng/mL of varenicline, highlighting the need to consider drug influence in suicide cases.
Area of Science:
- Forensic Toxicology
- Pharmacology
- Clinical Psychology
Background:
- Smoking cessation programs often combine pharmacotherapy with counseling.
- Varenicline, an alpha4beta2 partial agonist, is a novel agent for smoking cessation.
- Concerns exist regarding varenicline's potential link to psychiatric disorders.
Observation:
- A 39-year-old male, prescribed varenicline for smoking cessation, died by suicide.
- The deceased was on varenicline 1 mg twice daily for several months.
- A blood sample was analyzed for drug screening, including varenicline.
Findings:
- Liquid chromatography-tandem mass spectrometry was employed for sensitive varenicline detection.
- A validated method quantified varenicline in 1 mL of blood.
- The blood varenicline concentration was determined to be 10 ng/mL.
Implications:
- Therapeutic varenicline levels are not established in the literature.
- The potential behavioral effects of varenicline warrant consideration in suicide investigations.
- This case underscores the importance of monitoring mental health in patients using varenicline.
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