Chantix side effects
Sunday, March 08, 2009
Jonathan Foulds, MA, MAppSci, PhD
There have been relatively few studies of Chantix that included people with a mental illness, so that remains a concern. But last month a new study was published which examined side effects among Chantix users with and without a lifetime history of depression. The study, by Dr Jennifer McClure (Group Health Center for Health Studies, Seattle) and colleagues, compared the rates of side effects among people with (n=661), and people without a history of depression (516) who used Chantix to try to quit smoking while receiving phone and/or internet counseling. The study excluded people suffering from schizophrenia, bipolar disorder, and a few other illnesses. All participants received a telephone interview before starting treatment and 21 days and 3 months after their target quit date (i.e. approx 4 weeks and 13 week s after starting taking Chantix).
The first main finding was that, overall, ratings of symptoms such as depression or stress actually declined after the participants started taking Chantix (and tried to quit smoking), both for those with and without a history of depression. However, smokers with a history of depression felt more tense, irritable, depressed, and confused than those without a history of depression, 21 days after their target quit date (as they did at baseleine), and people with a history of depression who reported depressed symptoms were more likely to report severe depression than those without such a history at 21-day follow-up.
When examining actual change of mood, as compared with baseline, the majority of both groups mood improved after starting Chantix, but 10% of those with a history of depression had a significant worsening, as did 8% with no history of depression. Unfortunately this study was not able to compare these frequencies with people quitting smoking while taking placebo, but earlier placebo-controlled trials have not found a higher rate of mood worsening in Chantix users: quite the opposite.
One other thing worth noting is that both groups had very impressive quit rates, that were actually very slightly higher among those with a history of depression (45%) than those without: (42%) at 3 month follow-up.
So what does all this mean? The study authors interpreted the findings as suggesting that Chantix could be a particularly appealing treatment option for those smokers with a history of depression. Although such smokers are more likely to report common Chantix side effects and nicotine withdrawal symptoms, they had equally high quit rates without clear evidence of a worsening of mood.
So overall these results are somewhat reassuring, and suggest that perhaps we don’t need to be particularly cautious about Chantix use in those with a depression history. However, clinicians, patients and their families and colleagues should continue to monitor patients who are trying to quit smoking, and alert a clinician if a severe worsening of any symptoms appears to be occurring.
Here’s a link to a summary of the study:
http://www.ncbi.nlm.nih.gov/pubmed/19238488?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
Here are links to a couple of previous blog posts on Chantix and its side effects, including comments by many people who either did or did not experience side effects:
http://www.healthline.com/blogs/smoking_cessation/2007/04/chantix-how-does-this-new-quit-smoking.html
http://www.healthline.com/blogs/smoking_cessation/2007/09/does-chantix-cause-mental-health.html
Note: I have done consulting and other paid work for Pfizer, the manufacturer of Chantix, as well as for the manufacturers of other smoking cessation products. See disclosure statement on my homepage at healthline.com.
Labels: champix, Chantix, Jennifer Mcclure, jonathan foulds, side effects, smoking cessation, varenicline
17 Comments:
At Mon Mar 09, 06:52:00 AM 2009,
Sarah said…
Thanks for posting this! I received a script for Chantix that I will be starting on Thursday. I was very worried that I had made the wrong decision in going the Chantix route after reading many statements from people who have had horrible side effects. This report on findings from an actual study is reassuring to me. Thanks again.
At Tue Mar 31, 04:24:00 AM 2009,
James Rowan said…
This medication has promise in helping smokers, however it is still a dangerous substance. There is still a 50/50 chance that patients will experience severe psychotic side effects. That means that patients might be ok or they might want to claw their faces off, literally. I feel that it is appropriate to have more testing/trials with this drug. Good luck to all.
At Sat May 02, 04:46:00 PM 2009,
Ross said…
Is the thought here that the reason for the Black Box Suicide warning now on Chantix might be because it might cause depression especially with people that have a history of depression?
I can say from my own personal experience that the suicide ideation has nothing to do with depression. It is out of sheer terror, confusion about reality, and losing one's mind.
While I myself did not have suicidal thoughts at the time that I was admitted to the emergency room. I can certainly say that had doctors not been able to convince me that my delirious, psychotic state that Chantix induced was going to end once it was completely out of my system, if I could just hold on, I probably would have become suicidal within a matter of hours/days just to end the terror and losing of reality as my sane mind slipped away. Thankfully I had informed medical staff stepped in with all the right treatment and ushered me to safety and health quickly.
It had nothing to do with depression. Chantix is so energizing, bordering on mania without the euphoria, you stop sleeping almost all together regardless of the sleeping pills I was prescribed to help me cope, etc. I have no history of mental illness, depression, anxiety or chronic insomnia. I have never experienced anything like this in my life and thankfully several months after stopping Chantix, I have my own brain back again.
I have read all of your articles and the comments sections in the link you provide. Again and again I recognize my own exact symptoms in others' tales. This is a very real possibility for anyone prescribed this medication and they have no way of predicting who it will effect in this way.
I have quit smoking for months and years several times previously with none of these side effects. I find Pfizer and even this author's attribution of these side effects to mere nicotine withdrawal or other health issues to be disingenuous of the effect this medication can and does have on people. This study does nothing to explain away my experience.
My excellent doctors attribute my case 100% to Chantix and reported it to the FDA. While I make no implication about the frequency of these side effects (altho a nurse know had 6 similar cases in the last 6 months at her place of enployment), please do not deny those of us who have them and their doctors the truth of our experiences of this very dangerous drug (for some people). More research is required and IMO, Pfizer should pull the drug off the market until they can provide better predictability for whom it will drive mad and who will be safe from harm before more people die.
For those of you taking it, see your doctor weekly for very close monitoring. My regular doctor was unfamiliar with the drug or side effects when she prescribed it. Ask family members and friends to let you know if you start acting weird (my husband noticed weeks before I did but at the time didn't correlate to Chantix). If you at all begin feeling anxious, out of sorts, unusually stressed, easily confused, like you can't do your job, or just in any way not like yourself, see your doctor immediately about getting off Chantix. Don't try to wait it out as I did. Be aware that suddenly stopping can make these symptoms worse temporarily (up to 10 days) while your body gets off it. I even began hallucinating. I wish I had known to wean off to at least make that part less terrifying.
Be careful out there and good luck with the quitting smoking. Despite all that I experienced, Chantix didn't even manage to get me to do that.
At Sat May 09, 05:15:00 AM 2009,
Anonymous said…
Sarah I felt the same way. Purchased the Chantix and debated on whether or not to start it due to the possible mood side effects. I don't like the idea of taking medications unless it's absolutely necessary. After a month of the Rx sitting around the house I decided to start it and I'm now on day 6. I feel that it's working and although I'm still smoking it's not as frequent. Most of the time I don't think about having one. Being on Chantix, though, I find that I need to keep busy. If I don't I feel as if I'm moving in slow motion. It's a weird feeling. Best to you on quiting smoking.
At Wed Jul 29, 08:23:00 AM 2009,
Anonymous said…
Ive been on Chantix for 4 weeks now. I have not smoked since day 4. I have not felt depressed in anyway. No panic attacks, no suicidal thoughts. I was a little bit worried prior to taking it, with all the horror stories, but I have not experienced any of the side effects. I think this stuff is great. Quiting is difficult, but Chantix has helped me.
At Wed Jul 29, 04:21:00 PM 2009,
Anonymous said…
if there is anyone with type 2 diabetes,you may want to rethink taking chantix. One of the side effects that isnt very well know is that it will raise your blood sugar thru the roof. So if you are borderline diabetic I would not take it, Iam now paying the price, and I have been off it for a week
Good Luck.
At Sat Aug 22, 06:38:00 AM 2009,
Anonymous said…
I have a concern for down the road. My husband has quit smoking with the help of Chantix, was a year in March. He had a few dreams but not much else for side effects. His problems came after getting off chantix. He has a feeling of loosing control, nothing matters to him not even family. This is not him and he wonders if it is the Chantix. Depression, cant think, suicide and no feelings for things that mean the most to him. Is this Chantix effect? It is very scary, we have been married for 27 years and there is nothing I can do. Anybody have some feed back? Thanks!
At Mon Aug 24, 03:57:00 PM 2009,
Jonathan Foulds, MA, MAppSci, PhD said…
Dear anonymous of Aug 22nd,
It is impossible to say what is causing your husband to feel this way, but it is clearly a concern. He should see his family doctor and arrange for an appointment with a mental health professional your doctor recommends.
Men are often reluctant to take that step, but it sounds like the right thing to do in order to sort this out and start feeling better.
At Fri Sep 11, 02:00:00 PM 2009,
redleg said…
I did 7 days with the .5 mg pills, then stopped smoking and started 2x day w/1 mg, per the box. No real nicotine withdrawal for the next 9 days, then some very strong withdrawal feelings for the past 2 days. I have noticed that I have to change some behavior because I tended to chainsmoke while driving or at the computer. We will see how this works. I have smoked for over 40 years and was doing a minimum of 2 packs/day before I tried Chantix. Drove 2100 miles over labor day, the longest I've driven without lighting up, ever. The only side effect I've experienced in 3 weeks is a very minor heartburn and maybe slight headaches. Not sure if the headaches are Chantix related or not. No depression.
At Fri Sep 11, 02:03:00 PM 2009,
redleg said…
3 weeks into the program. went from 2+ packs/day to 0 at the end of the first week. Strongest urges are my activities with highest smoking: driving and sitting at the computer. I did 2100 miles over labor day with no smoking. I have had very strong withdrawal symptoms for the past 2 days, but they go away with the afternoon dose. Been smoking for 40 years, so I expect some nicotine withdrawal symptoms. The only side affects I've seen are minor heartburn and, maybe, minor headaches.
At Sun Sep 20, 05:56:00 AM 2009,
Anonymous said…
Started Chantix on September 2nd, 2009. The day before my quit date I was very nervous and afraid of failure. On day 8 I quit just like the plan. I was smoking less before that but felt like I was doing it out of habit. After 4 days of taking the 1 mg twice a day, I had 2 days of craziness. I was depressed, cranky, suicidal, did not feel like myself at all. I decided on my own to take less of the meds and now cut my pills in half. I still want to smoke out of habit but not out of need. I have been on Chantix for 19 days now once I quit smoking on day 8 I have now been smoke free for 12 days. I am sleeping more not less.I feel like myself. Not all meds work the same on everyone. You need to help yourself realize the side effects. I am doing GREAT!
At Thu Oct 08, 02:04:00 PM 2009,
Anonymous said…
Dear anonymous of Aug 22nd,
My God, it's like you were speaking for me....I have been married 24 years, my husband took Chantix last May for 4 months and he has been insane since...I just don't know what to do to reverse his symptoms, we are on the verge of divorce now because of the Chantix side effects...
I cannot file a lawsuit against Chantix because unfortunately he took Chantix without a prescription, we got it from a friend, and for that reason I cannot file a lawsuit.
I need help desperately with information as to what to do to reverse these symptoms if they actually can be reversed.
At Wed Oct 14, 04:04:00 PM 2009,
Anonymous said…
I started Chantix 2 1/2 weeks ago and noticed that I wasn't getting the urge to smoke very often after about seven days - so that's a good thing. However, after a meeting yesterday, I threw my notes down on the conference room table and started to express my frustration and anger in front of my manager; we then had a "closed door" meeting. Until then, I did not realize how my attitude had changed. I am also having problems sleeping and have had severe migraine headaches every day for the past two weeks. While taking "the pill" this morning, it dawned on me that my change in behavior, my sleeplessness and the migraines could be due, in part, to the drug. I have called my doctor's office and intend to cut the dosage in half unless otherwise advised.
At Tue Oct 20, 05:42:00 AM 2009,
redleg said…
I stayed on Chantix for 8 weeks. All I noticed was increased heartburn and a desire to smoke when I got hungry. During the last 10 days, I had to remind myself to take the evening pill. Stopped completely 2 days ago and haven't noticed much in the way of withdrawal symptoms. Downside, bet I gained 20 lbs.
At Sun Oct 25, 10:08:00 AM 2009,
Anonymous said…
Next week it will be 2 months that me and my husband have quit. I feel it has been an extremly long haul. I have a history of depression and take prozac. I have also smoked for over 35 years. I find I experience most of the side effects only more extreme including acne and weight gain. I sure hope that the above side effects end when I have finished with Chantix.
At Wed Nov 04, 05:25:00 PM 2009,
Anonymous said…
I hear you I am going through the same deal with migrane headaches everyday and my attitute has changed...is it really worth it.. this is some bad mojo medication
At Wed Nov 04, 08:02:00 PM 2009,
Anonymous said…
I don't recommend this to anyone I would much rather my smoking husband back than this psychotic paronoid person I'm dealing with now! My husband had been known to quit previously but always went back. I saw this drug on the news and advised him of it (big mistake)Needless to say he is now dipping but is crazy and has to take other medications to control his feelings it sometimes helps and sometimes doesn't. It has ruined our lives, for us and our children we are not the all american family anymore! Since he has not attempted suicide we dont get to sue, but I guess when he does or dies maybe then the company will feel my pain is worth alittle something! Maybe after enough people die from going crazy they will feel the need to remove this medicaion from the shelf, but right now a few lawsuits are nothing compared to the amount of money they are getting from the scripts they are filling. Sorry but I am angry!! i want my husband back!! Oh by the way it is out of his system he has been off of it for 2.5 years, it's had a lasting effect.
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