About 5 million Americans are currently living with heart failure (HF) and an astounding 24-42% also suffer from depression. One meta-analysis found a greater than 2-fold risk of death in patients with HF and comorbid depression. Depressed patients with HF are more likely to be hospitalized, seek care from emergency rooms, and rack up big bills. Not surprisingly, patients with HF and depression have a much lower quality of life when compared to HF patients without depression. Clearly, this is BIG problem. But can we do anything about it?
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Persons diagnosed with a psychiatric disorder consume nearly half of all cigarettes smoked in the United States! Seven first-line therapies have shown to increase long-term abstinence rates, with bupropion sustained release (SR) doubling and varenicline tripling the odds of quitting. However, the FDA issued black box warnings in 2009 regarding increased neuropsychiatric events and suicidality with bupropion and varenicline use. Thus many clinicians have been reluctant to prescribe these agents in persons with mental illness. The EAGLES study compared the efficacy of non-nicotine therapies to nicotine replacement therapy in smokers with mental illness