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.
Still, 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.
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