Suicide Attempt in a 38-Year-Old Patient on Varenicline While Intoxicated With Alcohol

Varenicline is one of two non-nicotine replacement therapy medications approved by the FDA for smoking cessation. It has also demonstrated some success in trials for the treatment of alcohol use disorder. In this case report, we present a case of a 38-year-old male with a history of alcohol and tobacco use disorders and no other psychiatric history, including no history of suicidal ideation or suicide attempts, who was admitted to an inpatient psychiatric facility after a suicide attempt while acutely intoxicated with alcohol one week after starting varenicline treatment for smoking cessation. Reports from the media, and literature from the FDA and manufacturers of CHANTIX^® have mentioned a potential interaction between varenicline and alcohol that can subsequently cause "unusual and aggressive behaviors" that are "often accompanied by amnesia to the events"; however, we were unable to find any case reports related to a potential interaction between the two causing a suicide attempt in a PubMed search. Therefore, to our knowledge, this represents the first case report of its kind.