Dr. Gnanasegaram is a psychiatrist, New Hampshire Hospital, Concord, New Hampshire, and a clinical instructor, Department of Psychiatric Medicine, Geisel School of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. Dr. Stanciu is a PGY-5 addiction psychiatry fellow, Department of Psychiatric Medicine, Geisel School of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. Dr. Ahmed is a PGY-3 general psychiatry resident, Department of Psychiatry, Nassau University Medical Center, East Meadow, New York.
Disclosures The authors report no financial relationships with any company whose products are mentioned in this article or with manufacturers of competing products.
4. Does the patient have another comorbid substance use disorder?In the EAGLES trial, those who had active substance use in the past year or were receiving methadone or buprenorphine/naloxone were excluded.
5. Does the patient have any medical conditions? Does he or she have a history of seizures or eating disorders?It is important to determine if a patient has a seizure disorder or another medical condition that is a contraindication for using varenicline or bupropion.
In the EAGLES trial, most adverse effects related to the medications administered involved sleep (insomnia) or the gastrointestinal system (nausea). The psychiatric cohort reported some anxiety with bupropion.
6. Have you discussed smoking cessation and a treatment plan with the patient at every visit? In the EAGLES trial, participants received 10-minute cessation counseling at every outpatient visit.
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