Chantix and mental illness - what are the facts?
Sunday, August 12, 2007
Jonathan Foulds, MA, MAppSci, PhD
http://www.healthline.com/blogs/smoking_cessation/2007/04/chantix-how-does-this-new-quit-smoking.html
People suffering from major mental illnesses were excluded from the initial placebo-controlled trials of varenicline (Chantix), which showed that it is both safe and effective in helping smokers to quit. It is normal practice to exclude certain categories of patient from trials of new medicines, prior to the drug being approved for sale to the public. Often the reason is that patients with certain diagnoses are more likely to be taking medications that may affect the condition being treated (e.g. antidepressants could theoretically affect smoking cessation, as at least 2 antidepressants are effective for smoking cessation). Sometimes it is partly to protect those considered “at risk”, from taking an unlicensed experimental medicine. What we end up with is that many new medicines have mainly been studied in people who are relatively healthy, apart from having the condition the new medicine is designed to treat. Chantix is like many new drugs in this respect. It is also very common, especially for new medicines that are very widely used, for reports to appear of unusual side-effects occurring in some patients. I’ve published a few such reports myself.
However, it is not until fairly thorough additional placebo-controlled studies have been published in more patient groups, that we can tell with any confidence whether the new drug really does cause problematic side effects in certain patient groups or not. Sometimes such studies are never carried out and in that case we need to rely on the reported experiences of clinicians treating those patient groups over a period of time.
One thing we have to bear in mind is that when a person starts using Chantix, that’s not the only thing that’s changing. That person will also be trying to quit smoking. Quitting smoking itself causes a number of changes, including the increases in nicotine withdrawal symptoms I’ve talked about before (see link below), and also a slowing in metabolism of some medications, that could cause an increase in the blood levels of the drugs contained in those medicines (I’ll discuss this in a future post). So some symptoms may be related to quitting smoking, rather than Chantix per se.
So if I had a relative who smoked and suffered from a mental illness (like schizophrenia, bipolar disorder or depression) and was taking medicine for that illness but wanted help to quit smoking, what would I suggest?
As with all the people I see who want to quit smoking, I’d describe all the available forms of help, including counseling, internet support and medicines. I’d recommend that they use these. With regards to medicines, I’d point out one advantage of nicotine replacement therapy, which is that it does not involve taking a “new” drug, - as they have been taking nicotine in a much more harmful form every day, for years. When discussing Chantix I’d point out that it had not been studied in many people with a serious mental health problem, and so it would be particularly important to discuss that option with their doctor and to allow the doctor to monitor their progress on that medicine fairly closely if the doctor decided to prescribe it. But if my family member had already tried nicotine replacement therapy and wanted to try something different, I wouldn’t discourage it. I’ve heard from many clinicians who have treated patients with mental health problems successfully with Chantix, and so I am not convinced yet that there is a markedly increased risk of adverse events caused by Chantix in such patients.
It would be helpful to hear peoples’ experiences of using Chantix, particularly if you have also had a mental health problem. If you feel that any medicine has caused a harmful effect, then you should tell your doctor, and particularly in the case of a new medicine, it may be appropriate to report this to the FDA. For further information on that procedure, visit: http://www.fda.gov/medwatch/
Here are the links to the recent case reports:
http://ajp.psychiatryonline.org/cgi/content/full/164/8/1269
http://ajp.psychiatryonline.org/cgi/content/full/164/8/1269-a
Here is the link to my previous article on nicotine withdrawal:http://www.healthline.com/blogs/smoking_cessation/2007/03/what-is-nicotine-withdrawal-syndrome.html
Labels: Chantix, mental illness, quit smoking cessation tobacco advice cigarettes, Smoking, tobacco, varenicline
40 Comments:
At Tue Aug 14, 12:03:00 PM 2007,
Anonymous said…
I have experience with one client who has Paranoid Schizophrenia. He was and remains on Risperdal consta 50mg injection every two weeks. he used the Chantix in Nov of 2007 in order to stop smoking. he was monitored each week for issues related to this product as well as for any other problems. he remains smoke free and is feeling well. He stopped smoking prior to Gastric Bypass surgery. he works fulltime and attends our treatment program once a week. he participates in Recovey groups and is a long time member in active mental health treatment.
At Wed Aug 15, 01:03:00 PM 2007,
Jonathan Foulds, MA, MAppSci, PhD said…
Anonymous,
Good to hear of people with schizophrenia successfully quitting smoking. There is an urban myth that this never happens, or that tobacco is somehow good for the illness. I've not seen any good evidence to support this and fear it leads to a double stigma - that of mental illness and tobacco addiction.
You can access further reports of success in quitting smoking among people with schizophrenia by Dr Jill Williams and colleagues at:
http://www.tobaccoprogram.org/staffarticles.htm
ps I'm assuming your client started on Chantix on Nov 06.
At Fri Aug 24, 05:37:00 PM 2007,
Anonymous said…
My ex-wife had a less rewarding experience with Chantix. She apparently took only 4 doses so was still smoking which would elimnate the actual withdrawl from adding to her demise. She was bipolar and on Lexapro and took her own life in June leaving behind two beautiful daughters. Seems to me that dopamine inhibitors and bipolar patients should be very closely monitored. Wish someone would have told her - I miss her!
At Mon Aug 27, 12:40:00 PM 2007,
Jonathan Foulds, MA, MAppSci, PhD said…
Dear Anonymous (of Aug 24),
What a terrible tragedy. My thoughts go out to you and your family. Thanks for posting this comment.
At Wed Aug 29, 08:14:00 AM 2007,
Anonymous said…
I quit smoking using Chantix (today is day 60). My 22 year old son is bipolar and on Depakote and Seroquel. He has been taking Chantix for 13 days. Hasn't stopped smoking yet, but has cut down.
What should I watch for as far as adverse reactions? The comment above about the wife's death obviously is hitting close to home for me.
Thanks for any advice.
At Wed Aug 29, 07:31:00 PM 2007,
Jonathan Foulds, MA, MAppSci, PhD said…
Dear Anonymous,
First of all I need to make clear that on a public blog like this I can only provide information of a general nature rather than directed at any particular individual.
So my general advice to the family member of someone trying to give up smoking is to do ones best to be considerate and supportive. For some that means not smoking in front of them and not leaving your cigarettes anywhere to tempt the family member, and for others it might mean staying out of their way and not getting into any arguments during the first couple of weeks.
Given the nature of nicotine withdrawal, you can expect the family member to be more moody, tense and irritable for the first month after quitting, to be more hungry, and to have poor concentration. All of the FDA approved medicines for smoking cessation should reduce the severity of these symptoms by about 50%, but not totally eliminate them. So it may be appropriate to give them the benefit of the doubt if they are a bit short-tempered as this may be the withdrawal talking rather than their usual self. It should pass within a week or two.
Although depressed mood is one of the nicotine withdrawal symptoms, it does not typically trigger a full blown depressive episode, and it is extremely rare (and therefore unexpected) for someone to attempt or commit suicide in the first few weeks of a quit attempt regardless of what medication they are taking. Generally speaking, making an attempt to quit smoking is more typically a sign that an individual is feeling strong and wants to make a change to improve their health – thoughts and behaviors that we generally think of as the opposite to self harm or suicide. However, for someone who has recently suffered from a serious mental illness, I believe that it is important to check in with the psychiatrist, other regular mental health professionals and wider support system more regularly around the time of an attempt to quit smoking. It is also important to inform those mental health professionals about the quit attempt and the medications being taken to support it. This is particularly true if the family member is taking a new medicine that had not been used by a large number of people with mental illness (like Chantix). It makes sense to check in more regularly at this time partly just to get extra support with the quit attempt, but also to discuss the medications and allow the prescriber to monitor side effects. The metabolism of some psychiatric and other medicines slows down when people stop smoking, meaning that they get higher blood levels from the same dose. In fact caffeine is one such drug. So someone who drinks 6 cups of caffeinated coffee per day may feel like they have had 10 cups, after they quit smoking.
Generally, the hardest part about being a family member of someone trying to quit smoking, is having to accept that we cannot really exert much influence other than making sure we are not the ones giving them cigarettes. The behavior of adult family members is outwith our control and we can only hope that they make good choices. If you are particularly concerned about suicide then you may find this article to be helpful:
http://www.webmd.com/depression/guide/depression-recognizing-signs-of-suicide
If the family member is receptive to offers of help and encouragement with quitting smoking then that is great, but as with many things within families, there can be a fine line between perceived helpfulness and perceived interference. Best of luck to all of you trying to quit and all of you with family members trying to quit.
At Fri Aug 31, 07:04:00 PM 2007,
Anonymous said…
I am the Anonymous who has a son on Depakote.
Your response to my question of what to look for is interesting. Your article has an attention grabbing headline and you raise huge concerns within that article for those that are being treated for a mental illness and taking Chantix. Someone posts that his ex-wife committed suicide while on Chantix so I ask what signs should I look for.
You completely ignore the fact that I quit smoking 60 days before my comment using Chantix so I obviously know the symptoms of nicotine withdrawal. And you go on to say that there is probably no problem ("it is extremely rare (and therefore unexpected) for someone to attempt or commit suicide in the first few weeks of a quit attempt regardless of what medication they are taking.")
It would be nice for you to make up your mind which side of the fence you are on. Thanks for nothing.
At Tue Sep 04, 07:21:00 PM 2007,
Jonathan Foulds, MA, MAppSci, PhD said…
Dear Anonymous of Aug 31,
In my original article I stated, "If my family member had already tried nicotine replacement and wanted something different,I wouldn't discourage it (trying Chantix). I've heard from many clinicians who have treated patients with mental health problems successfully with Chantix." Thats not sitting on the fence, and is clearly not intended to "raise huge concerns". I assumed you were interested in potential signs of suicide risk, which is why I gave the link to an excellent article by an expert on that subject. Just because one individual has recently quit smoking doesn't necessarily mean they are familiar with the typical pattern of nicotine withdrawal. This varies considerably between individuals. Some people (especially those using an approved med.) report few withdrawal symptoms and cravings, while others (including some using FDA-approved meds) report very distressing withdrawal symptoms and strong cravings. I understand that you are seeking specifc advice out of concern for your son. I hope you understand that on a public blog I have to provide somewhat general information based on the evidence I'm aware of. In the case of treatment of smokers with a mental illness with Chantix there is almost no published research (including few signs of worsening mental health from the placebo-controlled trials). In that situation it seems reasonable to try Chantix but to have regular contact with mental health professionals while quitting smoking.
At Wed Sep 05, 07:34:00 PM 2007,
Anonymous said…
I have written to a consumer advocacy group regarding my interest in seeing stronger warnings for the possible severity of the mood problems that I and others have experienced. I was not depressed before I took this drug for 6 days in February, and upon stopping it the 6th day due to an onset of joint pain (which appears fairly common among Chantix users) I had a complete mental meltdown of depression, crying for no reason, suicidal thoughts, panic...the worst mental state I have ever been in. I did not make it to the stop smoking date, so nicotine withdrawel would also not be a factor in my case. I am including some links below that are cause for concern, in my opinion. I would venture a guess the severe mental effects many are experiencing are not as 'rare' as it stated in the literature. To note, it has been 8 months since I took Chantix, and I continue to have muscle pain/stiffnes, confused thinking at times, memory issues...all of which I did not have prior to the drug therapy.
http://www.treatmentonline.com/treatments.php?id=710
www.wrongdiagnosis.com type in Chantix
It took a combo of 2 antidepressants and something for panic to regulate my moods somewhat, but other issues remain.
At Thu Sep 06, 08:24:00 PM 2007,
Jonathan Foulds, MA, MAppSci, PhD said…
Ok,
I'm now a bit concerned by the number of comments I'm hearing from people who have had bad experiences on Chantix. Here's what I propose to do:
1. I'll take another careful look at the publishd data from placebo-controlled trials where they measured effects on mood/depression etc, to see if that gives any clues.
2. I'll send a message to colleagues who are treating alot of patients with Chantix to see whether they have noticed patients having worrying experiences on Chantix.
The key question here is whether the rate of these experiences (and its the reports of depression/suicidal behavior/ideation that concerns me most)is greater than the background rate among smokers or smokers trying to quit. This is an important question and so it may take a while. In the mean time, my advice is to keep in close contact with your doctor while quitting smoking on a prescribed medicine, and if you you really feel you are having a bad reaction to the medicine, tell your doctor immediately. Once you feel OK again, focus again on quitting again. Remember that nicotine replacement therapy generally doesn't give serious side effects because you're not taking a new drug.
At Tue Sep 18, 10:41:00 AM 2007,
Mary said…
I started taking Chantix July 2. Stopped taking it on July 13th. That was also the day I met my mother for lunch and couldn't wait to return home to bed. I stayed in bed for two days. It was depression and had not been depressed like that in over 20 years. I have stopped smoking in the past and never experience anything like this. Not only did I stay in bed those two days the days before that I could barely get out of bed to go to work. I did absolutely nothing when I got home. I was very depressed. I did not get to the point of being suicidal but did go to the doctor. He said he had not heard of anyone else with these symptoms so basically dismissed my complaints. He did give me Prozac which I took for about month and then stopped. I am finally feeling better. However othe side effects like when I speak my grown daughter say I am not making sense. I am still having problems with my short term memory and joint pain. After stopping the medication I found wrongdiagnosis.com and checked it out. I am amazed of what people are experiencing. This should really be taken into consideration and not dismissed. I hope this helps as I have no form of other mental illness. At least now I am feeling happy again.
At Wed Sep 19, 12:51:00 PM 2007,
Kathy from Kansas said…
I am bipolar and took Chantix for four months. I was sucessful in quitting smoking with no side effects until(under doctor's orders) I decreased my dose by half for one month and then, after the month had passed, I stopped the Chantix all together. Also under DR.'s orders. I then went through the worst withdrawals I could ever imagine. Shakes, chills. vomiting, diarrhea,extremely high fevers, you name it. It was so bad some of my friends tried to get me to smoke but here I am, smoke free today. I just hope this gets posted because i wish someone would have told me.
At Thu Sep 20, 11:22:00 AM 2007,
Anonymous said…
I quit smoking after using Chantix for 6 weeks. No side effects at all. Maybe I am lucky!
At Thu Sep 20, 07:25:00 PM 2007,
Jonathan Foulds, MA, MAppSci, PhD said…
Kathy,
First of all, well done for succeeding in quitting smoking. Particularly as your symptoms sound awful. I don't recall hearing any reports of similar withdrawl symptoms from Chantix, and these were certainly not reported in the published clinical trials. Your experience is also very unlike typical nicotine withdrawal symptoms. A discussion with your doctor might help identify the most likely cause of those symptoms, butI'd be very surprised if it was Chantix withdrawal that caused it. Everyone is different but this sounds very unlike the typical experience of stopping Chantix.
At Tue Sep 25, 11:44:00 AM 2007,
Anonymous said…
I am bipolar and on wellbutrin, topamax and seroquel. I am successfully taking chantix and experiencing a few of the symptoms mentioned. However, alot of the symptoms that are being attributed to chantix here and at the original blog, I experienced before taking the drug. The dreams, and tingling extremities I do believe to be true side effects but I have to wonder about alot of the other problems. As a bipolar sufferer I know that I can have insomnia, cloudy thinking, memory loss, panic, anxiety during a manic phase and severe sadness and awful thoughts and lethargy, etc during depression. I just wonder if some of these people aren't suffering before they take the meds. And while I truly sympathize with the gentlman who lost his wife I just can't imagine that 2.5 mg of this drug would have altered her chemical balance to this extreme.
I am not saying these things haven't happened to these people, just that I was struck by some of these stories and it made me wonder.
At Thu Sep 27, 11:04:00 AM 2007,
Ellen said…
I have a client who has been diagnosed with depression, anxiety (panic attacks), and as bipolar. The client started Chantix a month ago, and when she returned to her doctor, expressed dissappointment because she had only been able to get down to 3 cpd (from 30cpd). She was referred to our clinic for nictotine dependence coaching/counseling. Client takes clonidine in the morning and during day as needed, and takes Zoloft, lithium, trazodone in the evening. Former etoh and cocaine, but none since early 2004. When she came to our clinic, she had been off of Chantix for 4 days and started smoking more heavily. I know the blood levels of antidepressants and other meds can elevate with nicotine withdrawal. My question: would this mix of medications interfer with or otherwise alter the intended effects of varenicline, explaining to some degree her inability to stop smoking compleletly after being on Chantix for a month?
At Wed Oct 03, 06:44:00 PM 2007,
Anonymous said…
Wow, I just came across this site and I find it very interesting. I myself do not have a chronic mental illness. However, I do work as a case manager at a small mental health agency and have seen two of my clients, one paranoid schizophrenic and one PTSD quit smoking via the use of Chantix. One reports no side effects, however the other reports many. I also have used Chantix to stop smoking (24 days and counting.) I take Chantix along w/ Topamax and Diamox for intercranial hypertension. Since starting the Chantix I have no memory at all and am confused all the time. I have also been so tired I can barely hold my head up. I also fell into a pretty major depression for a couple of weeks, but I came around. Otherwise, I had the routine intenstinal problems at first and still have some problems sleeping now and again, but nothing major. My schizophrenic client also reports being extremely confused w/ memory loss and fatigue. She also takes Topamax w/ the Chantix, Haldol, Trilleptal, and a wide variety of other psychotropics I can't even think of right now. My question to you is. Is the memory loss, confusion, and severe fatigue possibly contributed to the Chantix, which both of our doctors state no, or a mix w/ the Topamax? Any ideas?
At Sun Oct 07, 12:42:00 PM 2007,
Jonathan Foulds, MA, MAppSci, PhD said…
Dear Anonymous (of Oct 3rd),
Of course its hard to say with confidence what is causing any individual's symptoms - especially without talking to them directly. One should always consider nicotine withdrawal as a potential explanation. Poor concentration/difficulty focussing ones attention is a recognized nicotine withdrawal symptom and is more prominent in some individuals than others. I've known a few heavy smokers who have experienced dizziness so strong they couldn't drive, or such poor concentration they could no longer complete a cross-word puzzle. I have also been involved in a legal case where the defendant's confession was claimed to be inadmissable because his mind was so impaired at the time due to nicotine withdrawal (he was interrogated for 24 hours in a smoke-free cell)!
Also worth considering is an effect vie reduced metabolism of other medications theperson is taking. See my pprevious blog on this at:
Stopping smoking effects on drug metabolism. 9/16/07
http://www.healthline.com/blogs/smoking_cessation/2007/09/stopping-smoking-effects-on-drug.html
At Thu Oct 11, 05:21:00 PM 2007,
Anonymous said…
These are very intriguing issues and I applaud Dr. Foulds for his diligence in investigating these issues more thoroughly. I am a researcher who focuses on neuropsychiatric disorders, particularly cognitive impairments associated with schizophrenia. When first released, I was interested in the potential use of Chantix as a possible "cognitive enhancer" due to the reported relations between nicotinic receptors and sensory gating deficits in schizophrenia (Freedman, et al). I recently helped a colleague prepare a grant proposal to investigate this possible application in patients with bipolar disorder more thoroughly, and noticed that several projects have already been funded for this reason among patients with schizophrenia. So hopefully, the results of such investigations will soon shed more light on the specific issues (side effects, efficacy, interactions with other psychotropics, etc.) regarding use of this compound among individuals with various mental illnesses. My initial question for seeking out this site was whether there had been any preliminary questions regarding concomitant use of Depakote (or other anti-convulsants/mood stabilizers). So if you have any additional information on this, it would be most appreciated. Otherwise, we'll all just wait for more information to come out as further publications on this compound become available.
Keep up the good work. Consumers need informed advocates such as yourself!
At Thu Oct 25, 03:44:00 PM 2007,
cmvcat said…
This comment is for Anonymous 10/11. I'm a fellow researcher, but in cognitive psychology. I have a long history of depression with some anxiety and I have two brothers with schizophrenia and one with bipolar disorder. I began taking Chantix July 1, adding it to 300mg Wellbutrin, 100mg Lamictal, and 20mg Prozac. I was able to quit smoking after 2 weeks and no longer craved alcohol when stressed. Quitting smoking required almost no effort. I could sit next to a pack of cigarettes and a glass of whiskey and not be tempted to consume either. That in itself was wonderful. But the reason I quit smoking was so that I could fly to Europe without going crazy from withdrawl. In the past I have been a very anxious flier, needing a few drinks and some valium to tolerate the anxiety. I was able to fly across the Atlantic without either drugs or alcohol and with very little stress. I quit taking Prozac in mid September and reduced the Lamictal to 50mg, with my psychiatrist's approval, of course. Friends and family are impressed with the changes they have seen in my mood and behavior. Saying I'm more adaptable, for one. It feels to me like Chantix has changed something truly fundamental in my brain chemistry, in a way that impacted the hyper-vigilance I had attributed to being a genetic predisposition related to schizophrenia. It is a truly amazing drug - at least for my brain!
At Tue Nov 06, 07:22:00 PM 2007,
Anonymous said…
OK...So, here I sit staring at my new prescription of Chantix, reading this blog, and freaking out before I take my first pill tomorrow morning. The freaking out part comes most likely from my anxiety disorder for which I've been taking Paxil every day for the last 6 years. I'm 36 and have been smoking for over 20 years. I want to stop smoking, not only for myself, but for my 12 year old son.
I have to say now at this very moment, I'm second guessing the Chantix thing and debating going outside for a smoke to calm my nerves. Maybe it was a bad idea to read the blog.. I don't know. I'm really hoping that there is a solution to my dilema which doesn't include being rushed to the hospital after being awakened in the middle of the night by a feeling of impending doom. Any advice? Should I try another alternative first?
At Thu Nov 08, 12:48:00 PM 2007,
Jonathan Foulds, MA, MAppSci, PhD said…
Dear Anonymous of November 6th,
Your doctor presumably prescribed Chantix and so was confident that the likely benefits outweigh the potential risks. I think you doctor is probably correct.
But you can tip the scales further in your favor by not doing it alone. Keep in touch with your doctor during your quit attempt, and get support from freely available and helpful resources such as the national quitline or www.quitnet.com.
Check out a previous post that focusses on getting through the early stages.
http://www.healthline.com/blogs/smoking_cessation/2007/08/getting-through-first-few-weeks.html
Best of luck and let us know how it goes.
At Tue Nov 20, 11:54:00 PM 2007,
Anonymous said…
I have been on chantix for 8 weeks now and it has been a miracle drug for me! I am 6 weeks smoke free with little side effects from the chantix.
I am a member of the chantix thread (ccc) in the about.com smoking cessation forum for quitting smoking. You can do a 'poll' there or ask others about their experience with chantix.
It is a great support system for folks with questions about chantix.
Thanks!
Kimmie
At Wed Nov 28, 12:39:00 PM 2007,
Anonymous said…
I am bipolar and was given chantix today to help me quit smoking since I may have COPD...I am only 29. I am a little nervous about quitting since reading these side effects. I think everyone reacts differently though.
Wish me luck
At Fri Nov 30, 06:34:00 AM 2007,
Leigh said…
Hello all. I have read every single comment on this page, trying to get an idea of what it is going to be like when I get my chantix prescription. I am not on any other meds other than birth control. So I guess I don't have to worry about going "nuts" I am a little concerned about the dreams and the other minor side effects. I am very suceptible to anxiety attacks so I mean if I am gonna be waking up with my heart laying next to me in the bed I kinda want to know. Can anyone really elaborate?
At Fri Nov 30, 06:18:00 PM 2007,
Anonymous said…
Hi,
Some of you may find this new post to be of interest:
http://www.healthline.com/blogs/smoking_cessation/2007/11/new-study-of-chantix-in-comparison-with.html
At Fri Dec 07, 10:00:00 PM 2007,
Anonymous said…
I have been taking Paxil for panic disorder for 14 years. Recently, I was diagnosed with Fibromyalgia and was put in Lyrica for the pain and Amitriptyline to help me get into the fourth stage of restorative sleep. I then felt that I wanted to quit smoking and had asked my doctor to put me on Chantix. It took two weeks to actually not want a cigarette. I would light one up and it did absolutely nothing for me...it felt "flat" is the only way I can describe it. Then during the 10th week, three times I found myself flying into a red rage! I've been known to be angry and in no uncertain terms let people know how I feel, but this was way over the top angry...yelling and screaming! I've been going to counseling for an anxiety disorder since last Spring, but I don't equate the rage to being anxious. It could be the interaction of the various medications I take, which included the Chantix. I don't think it was withdrawal symptoms, since I hadn't had a cigarette in eight weeks. The only thing I could think of was that man in Texas who was taking Chantix, went into a rage, and someone killed him because of it. I immediately stopped taking the Chantix and haven't felt rage since. I want to quit smoking so bad! I have tried everything under the sun over the years and Chantix is the only thing that worked for me. I'm just feeling really frustrated at this point.
At Thu Jan 03, 02:40:00 PM 2008,
Anonymous said…
I am having severe memory loss after taking Chantix for only 3 weeks. In fact, I can't even remember how old I am.
I also have a constant mild headache. I'm only 4 days into quitting chewing tobacco, but I will now get off Chantix since there are so many other posts on people having memory loss.
Matt
At Fri Jan 04, 03:43:00 PM 2008,
Jonathan Foulds, MA, MAppSci, PhD said…
Matt,
Such severe memory loss is very unusual. I've seen patients who became so light-headed on quitting smoking (on no medicines or NRT) that they didn't trust themselves to drive. As always, the advice would be to speak to your doctor about this.
If you do come off Chantix, (and continue to stay off tobacco hopefully) I'm sure we'd all be interested to hear how you get on.
Best of luck.
At Mon Jan 14, 11:53:00 AM 2008,
Rachel said…
To everyone who is considering Chantix, or who has been on it a short time, please use with extreme caution. On New Year's Eve 2007, I lost a relative very dear to me. He had been on Chantix to stop smoking for a few months. Yes, it seemed to be working quite well. Then his behavior began to change. Never having had any previous psychiatric problems... and the last person you would ever believe to do so... he took his own life. This, unfortunately was not an isolated incident. A friend of mine, on Chantix a couple months, raving about how well it was working, almost succeeded as my relative had. Her husband got to her just in time to pull the gun out of her mouth. It is my experience that doctor's do not stress strongly enough the downside to this "miracle drug".
At Tue Jan 15, 06:50:00 PM 2008,
Jonathan Foulds, MA, MAppSci, PhD said…
Rachel,
Thanks for sharing this important information. If at all possible in these tragic circumstances, it may help others if the FDA were informed of these events.
The FDA urges both healthcare professionals and patients to report side effects from the use of Chantix to the FDA's MedWatch Adverse Event Reporting program
online at www.fda.gov/medwatch/report.htm
by returning the postage-paid FDA form 3500 available in PDF format at www.fda.gov/medwatch/getforms.htm to 5600 Fishers Lane, Rockville, MD 20852-9787
faxing the form to 1-800-FDA-0178
by phone at 1-800-332-1088 “
At Wed Jan 16, 05:19:00 PM 2008,
Anonymous said…
"EMEA concludes updated warnings needed for Champix
The EMEA has concluded that updated warnings to doctors and patients are
needed to increase awareness of cases of suicidal ideation and suicide
attempts reported in patients using Pfizer's Champix (varenicline; known as
Chantix in the US), which is indicated for smoking cessation in adults....."
Read full article at: http://www.medicalnewstoday.com/articles/91856.php
At Thu Jan 17, 04:26:00 PM 2008,
Jonathan Foulds, MA, MAppSci, PhD said…
EMEA is the European Medicines Agency. This is a similar decision to the one announced by the US FDA recently.
At Wed Jan 30, 04:20:00 AM 2008,
Anonymous said…
My first experience with Chantix was in 2006.I experiences extreme anxiety,depression,and panic.Blackouts with alcohol.I quit taking it due to the nausea not knowing that the anxiety and others were related.I tried this several times making my last attemp September 2007.It's now been 5 months since taking it and I am still having problems.It has put me into a deep depression along with the anxiety/panic again.My sleep is terrible because I dream constantly.I had to undergo a sleep study for this.I can't shut it off.These dreams are very vivid and real and bother me quite a bit.I also developed a sensitivity to medications.Prescription pain meds send me into mania.I never had any of this before Chantix.I did have some anxiety/depression issues before off and on,but now since using it,I can't seem to get out of the hole I'm in.I just wonder if I'll ever get any better.My thoughts are overwhelming/racing and a few times I had impulses of driving my car off the road.This stuff has really damaged me.
At Wed Jan 30, 06:41:00 PM 2008,
Jonathan Foulds, MA, MAppSci, PhD said…
Dear Anonymous of Jan 30,
It sounds like you have had an awful experience. I encourage you to see your family doctor and seek a referral to an experienced psychiatrist in order to have your depression properly treated. With treatment you can recover and feel much better in the future.
Best of luck.
At Mon Feb 11, 01:52:00 PM 2008,
Bob said…
I am a reporter for The Star-Ledger, the largest newspaper in New Jersey, and I am doing a story about Chantix - both its attributes and the recent concerns about safety. I would like to talk to some folks about their experiences. It would be helpful if you live in New Jersey, but it is not a necessity. I can be contacted at rcohen@starledger.com
Thanks
At Wed Feb 13, 08:18:00 PM 2008,
Anonymous said…
I believe there is some link between mental illness and the effects of Chantix. I have a family member who is bipolar. After only a short time on Chantix and during a time when the bipolar symptons were very much under control, this family member attempted to commit suicide. I would warn those with a history of mental illness to be careful. It may be a good idea to make family, friends and co-workers (anyone you are around a lot) to look out for sudden mood changes.
At Sun Feb 24, 01:18:00 PM 2008,
Anonymous said…
I am a woman in my late 40's who quit smoking using Chantix in Sept 2006, taking as directed the first 3 months. My GP doc recommended I continue with another 3 month supply just to be safe but I cut it to 1 pill a day instead of 2. During this same time my life became an emotional living hell. I was depressed, paranoid, irritable, manic and basically borderline psychotic. In Feb 2007 I began seeing a psychiatrist; after several visits he diagnosed me with bipolar II disorder. (I'd had one episode in my late teens 30 years ago but have not been treated since for a mood disorder.) In June I took two months sick leave off from my very responsible job of over 20 years because I couldn't function. I was suicidal at the darkest times. Finally I decided to taper off the Chantix. All during this nightmare, I asked the GP and 3 different psychiatrists, "What about the Chantix? Could it be the Chantix?" None of them thought it had anything to do with it. (God, no, don't stop taking it, you might smoke!) True story. I am just beginning to get my life back. Now, I'm not saying that this is all due to Chantix. I look back at a perfect storm of events and chemistry that came together to create this, but if I knew what I know today, I NEVER would have taken that drug. I've read that the clinical trials were not conducted on people with any psychiatric disorders. Well, for crying out loud, isn't there a greater number of that population that smokes? I feel stupid to have trusted the drug company and my doctors so totally. I'm hoping for a better 2008. Please be careful with this drug. I am smoke free and grateful for that, but at what cost?
At Fri Mar 21, 12:21:00 PM 2008,
Anonymous said…
About 7 months ago I took Chantix to stop smoking. After the third week I had completely stopped smoking. Around the fourth week I began to experience a significant psychotic episode. I had significant cognitive distortions,suicidal thougthts, and an unrelenting/debilating depression. Working as a social worker, I recognized immediately that something was wrong. I weened off the Chantix, and the episodes continued. I have since been on 4 different anit-depressants and am know seeing a Psychologist; nothing has been able to bring me out of this depression. I have consisently struggled with major depressive disorder since I was a teen, but have not experienced anything like this in over 15 years. I know people who took Chantix successfully, but I had no idea that it would trigger my depression to such an extent.
At Tue Mar 25, 07:58:00 PM 2008,
Jonathan Foulds, MA, MAppSci, PhD said…
Many thanks to all those who have and continue to post about their experiences and those of family members. Some of you have experienced terrible tragedy and it is very brave and helpful for you to share that experience. I have been working on treatment of tobacco addiction for almost 20 years, and although I'd met patients who had attempted suicide or asaulted someone while quitting smoking (long before Chantix came along) I've never heard so many people report fairly extreme disturbances of mood and thinking while quitting smoking before. So on the one hand these reports are very persuasive that this medicine may cause a serious reaction in some people. But then one recalls that over 5 million people have tried the drug, and there was no sign of these events in the original placebo-controlled trials. I'm also struck by the wide variety of patterns being reported...some having a bad experience early on while taking Chantix, and others only having a bad experience after they stop taking it. I've discussed potential mechanisms with colleagues, but I don't think anyone has come up with a plausible explanation or mechanism yet. It remains a puzzle that needs to be solved. I've been assuming that the effects must be mediated by the balance of the drug's effect as a nicotinic receptor blocker and its effect of stimulating dopamine release. But maybe it has some other effect we don't fully understand yet. Further studies are needed, but I also believe we can be helped to undertand this by listening to the accounts of people who have used this medicine (and others) to try to quit smoking. So keep writing in with your experiences, regardless of whether it involved Chantix.
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