Tag Archives: chantix

Chantix Questions Illuminate Hold of Cigarettes on Mind

The mentally ill consume 45% of the cigarettes smoked in America these days, the WSJ reports. A striking figure in its own right, the number takes on new significance amid reports of psychological troubles associated with Pfizer’s anti-smoking drug Chantix.

Nicotine increases the level of dopamine in the brain’s reward center — a powerfully addictive effect. And as reports have emerged of suicidal thoughts and behaviors in patients taking Chantix, Pfizer has pointed out that, even in the absence of drug treatment, quitting smoking can have a powerful effect on the mind.

But, the FDA suggested, taking Chantix — which binds to the same neural receptors as nicotine — may add to the psychological tumult, at least for some patients. And because the mentally ill were excluded from the drug’s pre-approval clinical trials, it’s hard to know where mental illness fits into the picture.

Chantix BoxStill, the benefits of quitting smoking are so great that some degree of risk should be tolerable in a drug that helps people quit. “If you have a history of depression, you need to be careful when you stop smoking that it doesn’t come back,” John Hughes, a professor of psychiatry at the University of Vermont and a Pfizer adviser, told the WSJ.

But for people who’ve failed to quit with a nicotine patch and are thinking about using Chantix, he wouldn’t avoid the drug over fears of mental problems: “The risk is so small under a physician’s care, and the benefit is so huge.”Bonus Smoke: One man’s strange Chantix trip landed in New York Magazine last week. “Maybe I should just go downstairs and leap in front of a tour bus,” the author thought at one point. “Or launch my head through the computer screen. All this seemed logical, but also weirdly funny, even at the time: I could see how crazy these impulses were, I could recognize them as suicidal clichés.”

Source: Jacob Goldstein

Talk (Cold) Turkey: Visit the WSJ’s forum on quitting smoking.

| Trackback URL: http://blogs.wsj.com/health/2008/02/19/chantix-questions-illuminate-cigarettes-hold-on-the-mind/trackb

Chantix Helps Smokers Quit

MARTINSBURG, W.Va. – The first time Brian Kelly quit smoking, in the 1990s, he had nicotine cravings like crazy even though he was using a nicotine patch and nicotine gum.

This year when Kelly decided again to try to kick the habit he returned to the patch and gum, until he read on the Internet about Chantix, a prescription anti-smoking pill approved a year ago by the U.S. Food and Drug Administration.

“It’s like a wonder drug as far as I’m concerned,” said Kelly, 63, of Martinsburg.

Kelly said he quit smoking in three weeks – a date he set through a quit-smoking class at Waynesboro Hospital in Pennsylvania – and didn’t face the withdrawal symptoms that occurred the first time he quit.

Chantix, made by Pfizer, blocks the nicotine receptors in the brain so people don’t get a buzz from smoking, nor do they suffer withdrawal symptoms when they stop smoking, said Dr. Paul Quesenberry, a family doctor with Cumberland Valley Family Physicians in Chambersburg, Pa.

“It’s been a really amazing addition to our regimen for getting people to stop smoking,” Quesenberry said.

Still, it’s not an immediate fix.

How long it takes to stop smoking with Chantix varies from patient to patient, but usually it takes weeks to months because people have to learn to break the habit as well, Quesenberry said.

According to Pfizer’s Web site, smokers should start taking Chantix one week before their quit-smoking date so the drug can build up in the body. They can keep smoking during that first week.

Dr. Dwight Wooster, a pulmonologist with Newman, Wooster, Kass, Bradford, McCormack & Hurwitz at Robinwood Medical Center, said he recommends his patients try to reduce how much they smoke before they start Chantix. Of the 22 patients for whom he has prescribed Chantix, about 17 already have quit smoking.

Most people take Chantix for up to 12 weeks, according to Pfizer.

The most common side effects include gastrointestinal problems such as nausea and constipation, and difficulty sleeping, doctors said.

Quesenberry said most people he’s prescribed Chantix to haven’t had problems with side effects.

Most people who experience side effects will tolerate them because the benefit of quitting smoking is so huge, he said.

Dr. Sanjay Saxena, a family doctor with Hagerstown Family Medicine, said he’s had patients ask about Chantix, whether they’ve tried other smoking cessation tools or not, because they’ve heard how successful the drug has been for others.

Health benefits

Kelly began smoking at age 7 when he was living in Brooklyn, N.Y., because it was a tough neighborhood and smoking was cool.

When he quit the first time, Kelly had been smoking as many as 4 1/2 packs a day.

He began smoking again around 2001 after several deaths in his family and got up to a pack and a half a day.

Since he quit with Chantix, Kelly feels terrific, he said.

His breathing has improved, and he no longer has a smoker’s cough.

The carbon monoxide that gets into the bloodstream from smoking can lead to heart disease and strokes, Quesenberry said.

Smoking also can lead to chronic lung diseases such as emphysema and cancers, including lung, mouth, esophagus, and cervical and bladder cancers, he said.

Lesa Spedden, 32, of Chambersburg, Pa., took Chantix to quit smoking so she would have more energy and to be an example for her children.

“I don’t want to be a hypocrite and say, ‘Now, you can’t do this.’ Meanwhile, I’m there huffing and puffing in front of them,” Spedden said.

Spedden said she truly enjoyed smoking and wanted something to help her not enjoy the habit. Chantix helped curb that desire. After taking the drug a few days, smoking cigarettes developed an unpleasant, bitter taste, she said.

Smoking didn’t appeal to her anymore.

The most immediate benefit is getting rid of the expense of smoking, Quesenberry said.

Chantix can be pricey and sometimes health insurance doesn’t cover it, but the flip side is the expense of cigarettes, Quesenberry said.

A one-month supply – a 1-milligram Chantix pill per day – would cost $60 to $65 without insurance coverage, said David Russo, pharmacist and owner of Russo’s Rx in Hagerstown.

Other options

Other options for smokers wanting to quit include the nicotine patch, nicotine gum, nicotine inhaler and the anti-smoking drug Zyban.

Saxena said Chantix has been more successful than other treatments, but there’s still a place for those other treatments. He’s had at least one patient who experienced bad nausea with Chantix.

For that person, he might recommend the nicotine inhaler, which gives smokers nicotine as well as something to do with their hands rather than handle a cigarette or turn to more food as a substitution.

Quesenberry said he typically hasn’t recommended the nicotine patch because it causes skin irritation, and smokers usually don’t like it because it doesn’t deliver that quick nicotine buzz as a cigarette does. Instead, the patch provides a slow release of nicotine.

While the taste of nicotine gum isn’t pleasant, it does a better job of providing a nicotine buzz, like a cigarette, he said.

Quesenberry said he would prescribe Zyban for smokers with significant co-existing anxiety or depression because the pill is actually an anti-anxiety medicine, marketed for the latter purpose as Wellbutrin. The drug, generically known as bupropion, was approved by the FDA in May 1997 as an anti-smoking medication and marketed under the name Zyban.

If someone specifically asked for Zyban because they knew someone who quit with it, Quesenberry would prescribe the person that drug, he said.

Wanting to quit is a big factor in succeeding quitting, local doctors said.

Quesenberry said he won’t prescribe Zyban or Chantix for smokers who don’t want to quit but say they want an anti-smoking drug because a family member wants them to quit, because they have to want to quit themselves.

A bit of psychology is involved, he said.

“Once it’s in the heart and they want to do it, it doesn’t take much. It’s getting people to where they’re ready to stop that’s the big deal sometimes,” Quesenberry said.

“If you’re not motivated, no medication is going to work,” Wooster said.

For more information about Chantix, check out this Web site:

U.S. Food and Drug Administration’s patient information sheet for Chantix: www.fda.gov/cder/drug/InfoSheets/patient/vareniclinePIS.htm.

Source: JULIE E. GREENE, The Herald-Mail Company