Based on this comprehensive systematic review of published randomised controlled trials, there is no evidence of an increased risk of depression, suicidal behaviour (that is, suicide or attempted suicide, suicidal ideation), and death from any cause associated with treatment with varenicline. Varenicline users, however, have an increased risk of abnormal dreams, insomnia, and sleep disturbances, which are consistent with findings from other studies and previously documented commonly reported side effects of varenicline (www.chantix.com). We reported our findings using two summary statistics (a relative measure and an absolute measure) and observed consistency with both methods. This meta-analysis adds to previous research (observational and experimental) that found no evidence for increased suicidal behaviour or depression with varenicline, the most effective drug for smoking cessation.4 The dangers of smoking are well documented, and the health benefits of stopping smoking are well known. Our analysis suggests that the benefits of varenicline for smoking cessation outweigh the as yet unproved risks of suicidal behaviour. In the UK, varenicline is recommended alongside bupropion and nicotine replacement therapy as first line treatment for smoking cessation.75 Therefore, the
