Friday, May 23, 2008

Where's the Good News about Chantix?

I hate to generalize about the media always seeming to sensationalize and report much more of the bad then good, but the latest flurry of Chantix news does not help to broaden my opinion. Despite some excellent news recently about the Pfizer's smoking cessation drug Chantix (more on this below), the headlines suggest otherwise, such as More Trouble for Pfizer’s Smoking Cessation Drug Chantix from the WSJ and Forbes' Pfizer's Chantix Going Up In Smoke.

This wave of "news" stems from recent reports that first the FAA banned pilots and air traffic controls from using Chantix, and subsequently The Federal Motor Carrier Safety Administration that oversees trucks and buses issued a warning that they would not qualify anyone currently using Chantix for commercial motor vehicle licenses. Both agencies based their decision from a report released from the non-profit Institute for Safe Medication Practices that examined adverse-event reports turned into the FDA and found 988 serious health problems reported in association with Chantix use, including seizures and heart trouble.

It is important to note that the ISMP is not a federal or regulatory agency, and it is not the FDA. The FDA reviewed these reports, and despite their eagerness to get out any bad news about medications, didn't seemed to concerned. This is because when millions of people start taking a drug, some people are going to have side effects. The side effects reported are rare and are consistent with side effects found in the studies that Pfizer submitted to the FDA.

However, looking at post-marketing side effects is very important. Chantix is a good example. As I blogged about previously, in the studies that the Pfizer submitted to the FDA, Chantix had few interactions and side effects (except nausea, which was usually mild and usually went away). However, because Chantix compared its drug to bupropion (the only other pill indicated for smoking cessation, but also used for depression), patients with mental illness were excluded from the study. What happened was that once the drug hit the market, and started to be taken by patients with mental illness, some patients and doctors observed worsening of their mental conditions, including suicide. This does not necessarily mean that this was caused be Chantix, because just stopping smoking can cause these effects. However, the FDA appropriately released an early warning back in November of 2007.
Do not get this warning confused with the recent news about the FAA and FMCSA. They are not related. The former is a warning from the FDA about newly discovered side effects and the later is an agency decision based on information from a non-profit regarding issues that the FDA knew about and didn't seemed too concerned.
Adverse event reporting is important, and it seems like the FDA is finally going to ramp of the process of reporting, which is currently voluntary and quite spotty.

However, in all the recent media storm about Chantix, very recent good news was lost. Hear are the headlines you didn't read.

New Smoking Cessation Guidelines find Chantix the Most Effective Pill to Help Smokers Quit
Earlier this month, the surgeon general released "Treating Tobacco Use and Dependence: 2008 Update" which is the latest smoking cessation guideline. The guideline builds on the previous document from 2000 showing that there are multiple therapies, including medications that are effective at helping smokers quit. In fact, medication (pills, patches, gum, etc. ) are so effective, the guidelines recommend these for EVERY smoker. Since Chantix was new, they looked at the data around Chantix. There is a table which shows the relative effectiveness of medications, and Chantix rose to the top. Tobacco smoke is the single leading preventable cause of death in the US. Guidelines clearly state that medications should be offered to all smokers who want to quit. Chantix is the most effective agent. That sounds like good news to me.

FDA Label Change to Chantix Reassuring
As mentioned above, the FDA looked into the issue of worsening of neuropsychiatric symptoms in patients taking Chantix. On May 19th, the FDA made the final update to the Chantix label, which was the following:

"Advise patients and caregivers that the patient should stop taking CHANTIX and contact their health care provider immediately if agitation, depressed mood, or changes in behavior that are not typical for them are observed, or if the patient develops suicidal ideation or suicidal behavior."

If you read between the lines, this is an appropriate warning, and not a serious precaution such as the dreaded "black box" warning. The label doesn't say that Chantix even causes these side effects (because they may not) but doctors and patients, especially those with mental health disorders should look out for these symptoms. This should be reassuring to patients and providers that they can use Chantix without concern, as long as they take this observation into account.

Why is it that we don't see these headlines in the media? The result is unnecessary worry and fear by doctors and patients.

79 comments:

Omnibus Driver said...

I've tried the patch, the gum, the nasal spray and Wellbutrin. NOTHING worked... until Chantix.

You don't get the nausea if you follow the directions and take it with food.

You don't get the headaches if you follow the directions and take it with a full glass of water.

The dreams are nothing in comparison with the full-blown, all night long horror stories I had when I was on the patch.

You don't get the cravings. You just eventually don't want a cigarette.

You don't eat everything in the refrigerator.

You don't get the antsies.

You don't want to bite the head off of every person who so much as glances in your direction.

Personally, I'm betting the tobacco lobby doesn't want the media to hear this good news, because finally something has made it EASY to quit smoking. And Lord knows big tobacco wouldn't want that....

One note -- Chantix has affected my Cumadin levels. If you've got a patient on Cumadin, expect their numbers to spike if they're on Chantix, too.

James Rowan said...

I have had several seizures that have been to Chantix. I think Pfizer should take this drug off the market, take it's losses and move on. Sorry doctors, this is medication that is dangerous to your patients. Do the right thing and help your patients. Remember your oath "Do no harm!"

Dr. Matthew Mintz said...

I am sorry that you experienced seizures. However, there is no good evidence that Chantix causes seizures, and if it does, it is extremely rare.
In the initial study, and in the FDA package insert there are no reports of seizures and no warnings of seizures as even a rare side effect.
In the recent report that triggered the media stories, there were 86 reports of seizures. However, this is after millions of patients have taken the drug. It is hard to show that there is a clear link.
Any medication can cause any side effect in any patient. All medications are associated with side effects. Tylenol, Advil and even Aspirin might would likely never be approved today due to their side effects/risks; and yet they are considered safe enough to be over the counter. Compared to other drugs, Chantix has a very good safety profile.
If you were perfectly fine, took Chantix, and then had a first ever seizure, it is possible that Chantix played a role. However, smoking is the single leading preventable cause of death in the US, and 21% of adult Americans smoke. The benefits of Chantix in helping people quit smoking seem to be far outweighted by the few out of several million who may have a side effect, even if as serious as a seizure.
There are not perfect medications that do exactly what we want, all the time, without any side effects are harm. There has to be a risk benefit ratio, and for Chantix (at least in my opinion) this risk/benefit ratio is pretty good.

James Rowan said...

Excuse me, Doctor, I have a question. Why are pilots, air traffic controllers, crane operators, train operators, bus drivers, and truck drivers restricted from taking Chantix? From what I understand, it's because they might experience loss of consceicness or seizures. I know that doctors are impressed with Chantix's ability to supress the urge to smoke, but my doctor is not. He saw first hand how I was before, and was not happy about how the drug affected me. Now I know you have not changed your mind about Chantix, but I am certain you will as more time passes. I do hope everyone stops smoking, I just think that Chantix is not the way, for me, and soon-to-be millions of others. Thanks

Dr. Matthew Mintz said...

Here's the reason for the restrictions:

In the report that caused the hype, this independent group reviewed all adverse events reported to the FDA since the laucnh of the drug. In there findings they state, "a total of 173 serious events described accidental injury, including 28 road traffic accidents and 77 falls, some leading to fractures of rib, facial bones, hand, ankle, spine, and lower limbs. In these cases a variety of potential causes were identified, including loss of consciousness, mental confusion, dizziness and muscle spasms."

Now certainly, at first glance this sounds bad. However, according to the CDC, in 2005 there were 117, 809 deaths from all accidents, 19, 656 from falls, and 45,343 from car accidents. And these are just the deaths. There are likely many more accidents not resulting in death.
There are about 2 million motor vehicle accidents a year requiring an emergency room visit. For argument's sake, let's tripple that to include all serious motor vehicle accidents. With approx 300 million US citizens, the motor vehicle accident rate would be about 2% annually. There have been about 5 million prescriptions for Chantix written. Thus, about 100,000 of those taking Chantix were likely to be involved in a motor vehicle accident. Yet, only 28 people reported an accident they thought might be due to Chantix. Though the 100,000 is a rought estimate based on national data, even if it were 10,000; 28/10,000 still doesn't seem like Chantix is liked to traffic accidents.

However, despite the big picture, this indpendent group which tries to be a watchdog for drug safety stated "We have immediate safety concerns about the use of varenicline among persons operating aircraft, trains, buses and other vehicles, or in other settings where a lapse in alertness or motor control could lead to massive, serious injury."

Even if their reports are true and accurate, I do not agree with this conclusion. However, certain agencies chose to act on this, which lead to substantial media attention. I believe this is a shame because patients who could really be helped by Chantix will be affraid to take it. If you compare the safety of Chanitx to other commonly used drugs such as Viagra or even over the counter medications like Tylenol, you will see that Chantix has a much favorable side effect and safety profile.

James said...

Doctor, please listen carefully, I think everyone should quit smoking, and if they don't, they should keep trying. I agree with you Chantix might be ok. Why can't Chantix be tested on non-smokers, just to see how they react to the medication. They might be okay, or they might want to claw their face off...literally.

Dr. Matthew Mintz said...

All medications are tested on health individuals before being tested on actual patients. Prior to approval, medications are tested on thousands of patients, with careful attention to safety issues. Chantix was thoroughly tested prior to it being released to the general public. The one population that it had not been extensively tested were those patients with mental health disorders. In those patients, there have been some reports that their conditions have gotten worse, including suicidal ideation. Since stopping smoking can cause this as well, it is unclear whether or not this was due to Chantix or stopping smoking. Regardless, the FDA added a warning to Chantix regarding worsening of neuropsychiatric symtpoms. It added no additional warnings about seizures or accidents.
James, I understand that you had tremendous suffering likely due to Chantix,and I am truly sorry for that. However, the big picture in my opinion is that the small (even if serious) adverse of effects of Chantix are substantially outweighed by its benefits. It is a pretty safe drug for a pretty significant problem. Approximately 400 Americans die each year due to anaphylactic reactions to penicillin based antibiotics. However, one would not suggest that penicillin is dangerous or should be removed from the market. There is not perfect drug that works 100% of the time in all patients with 0 adverse effects.

James Rowan said...

Doctor, I love you like a brother. I really you think you are doing the best you can to justify this drug. I have a request for you, simply take one pill, just one. That's all you need. The pleasure receptors in your brain are no different than those of smokers, so there is no reason to think you would react any different than a majority of people. I still have not seen evidence that non-smokers have been used in any study concerning Chantix. I am my own man, I will not allow myself to used by anyone pro or con, I know how I felt, I know what happened to me, and I am scared for others. Again, I do think everyone should stop smoking, I just think there should be more evaluation regarding Chantix, with both smokers and non-smokers. Thanks for your time.

Shep said...

Y'all please keep this dialogue going. I am considering the chantix regimen and find your discussion most pertinent. Thanks.

James Rowan said...

Shep, I am no doctor, and I find Dr. Mintz to be kind and respectful in his responses. I can tell you that after taking just one .5 mg of Chantix, I had the worst nightmare of my life. I (along with thousands of others) went through weeks of very bad side effects. I think Dr. Mintz will agree that there is no other medication that works on the brain the same as Chantix. Good luck, but if you feel, I don't know, strange, out of place, overly emotional, have blackouts, or other out of the ordinary thoughts, you might want to quit this drug immediately. I hope you quit smoking, you will be in better health if you do. Dr. Mintz, I know we can agree on at least that.

James Rowan said...

Shep, one more thing, if you want to know what you might experience, there is an interesting article in New York magazine by Derek De Koff. The title is "This is my brain on Chantix", you can search for it, free of charge. I'm not a professional writer either, but he seems to have captured the experience that I and apparently thousands of others have had. I've said enough, thanks Dr. Mintz, keep up the good work.

Dr. Matthew Mintz said...

James, you are correct that Chantix works on the brain like no other drug. The author of the NY Times piece talked about bad dreams and feeling strange, which sounds like happened to you. Strange dreams are indeed known side effects of Chantix. In fact, anything that works on the brain, specifically antidepressants, can make people feel very different mentally. These are uncommon, but known side effects. As mentioned, there is no perfect drug. If a patient has a side effect on a drug, then the patient in conjunction with the doctor should decide whether or not to continue to take the drug. For example, the biggest side effect for Chantix is naseua. About 1/3 of the patients will get it. However, it is usually mild and usually goes away. That said, in the studies, about 3% of patients stopped taking Chantix due to nausea. In other words, if you are having side effects from any drug, then you need to decide whether or not it is worth staying on the drug or trying an alternative. The minute you felt strange on Chantix, you should have contacted your physician to discuss this.

The issue boils down to whether or not Chantix is safe. With the original label update about neuropsychiatric symptoms and the recent media attention given to the report that led the FAA to ban pilots from taking it, I believe that a pretty darn safe medication (in comparison to other medicines including those over the counter) that is the most effective agent we have for a pretty bad problem is getting maligned in the media. I am concerned that thousands of patients who would be good candidates will not take the medication because of unnecessary fear of dangerous side effects.
Vioxx has taught us all a great lesson. However, amplified by political agendas and media hype, the pendulum has swung too far and patients are unnecessarily worried about medications that are safe and effective. As further evidence, please see my recent post on a ridiculous article gaining a lot of attention called "8 drugs doctors would never take."
P.S. I would have no hesitation trying one 0.5mg pill. However, Pfizer does not sample Chantix. Even as a physician, the only way I could get one pill would be to have a prescription. I do not want to ask for a prescription because I don't want to have on my medical record that I have taken a medication for smoking cessation, since I have never smoked, and that small piece of data could affect future life insurance coverage.

James Rowan said...

So...Is Chantix is safe for non-smokers or not? Am I trying to malign this medicine, or am I trying to get others to do the right thing, as responsible Americans, and report their experiences about a potentially dangerous drug. Am I part of the tobacco companies' effort to discourage smokers from quitting or not. Are you paranoid about it? Congratulations, you have just experienced one of the mild side effects of Chantix. I can only imagine how this medication would affect you. Oh yeah, only smokers are subjected to the misery of the effects of this drug, for their own good. Let me say....again, I DO want smokers to quit, I also think that nicotine is very dangerous and addictive. Thanks (That author wrote it in the New York Magazine not the New York Times)

Shep said...

Mr. Rowen,
I have taken the plunge. Day 1 last night, slept well. Cost me $137.99. Health insurance cost me $428 a month. They had zero coverage for chantix.???
Anyhow, I'll keep y'all apprised of my cessation experiences. Top o' the day.

Dr. Matthew Mintz said...

Shep,
I am glad you are taking an important step toward quitting smoking.

James, we are just not going to agree on this.
My position is that though Chantix can cause some side effects, even serious side effects in rare cases, it is generally a very safe and effective drug. In fact, it is the most effective agent for smoking cessation.

Your position is that you experienced horrible side effects from Chantix and that everyone should be warned about this.
As a progressive, I can understand your distrust of Big Pharma. Certainly there are some examples of harmful drugs that either should not have been approved or stayed on the market too long. Though we should continue to be careful about new agents, Chantix is just not one of the bad guys(though the media would suggest otherwise, and my cause for concern).
Hopefully, the pragmatist in you can see that the benefits of the drug far outweight the risks, and any patient experiencing possible side effects from any drug should contact their physician.

Below I have included links for the prescribing information of Chantix, Viagra and Zyrtec, the later which is considered so safe that it is now over the counter. I would argue that in comparing the prescribing information, including warnings and side effects, that Chantix is the safest of the three.

Chantix
http://www.fda.gov/cder/foi/label/2008/021928s008lbl.pdf

Viagra
http://www.fda.gov/cder/foi/label/2005/020895s021lbl.pdf


Zyrtec
http://www.fda.gov/ohrms/dockets/ac/01/briefing/3737b_13_label-zyrtec.pdf

James Rowan said...

Hi. I still love you like a brother. Doctor, my position is that I and thousands of others have had severe problems with Chantix. My position is that smoking is terrible, and everybody should quit. My position is that I and thousands of others might have permanent brain damage, we just don't yet. I do not have any beef with any Pharma company, I hope Pfizer will survive and prosper, I own stock in Pfizer, and I'm not going to get rid of it. I do not have any political agenda, I vote and that's about it. This medicine is toxic to me, and thouands of others. There will be more patients giving their experiences, I hope the pragmatist in you will realize thousands of different people from thousands of different areas of the country have not gotten together in some sort of conspirasy to make you look bad. I am not a member of the media, and I will not be disrespectful to you by suggesting that you are a part of a media campaign that advocates use of this drug. Thank you once again

Dr. Matthew Mintz said...

"I and thousands of others might have permanent brain damage, we just don't yet."

First, though Chantix and other agents working on the brain have been associated with neuropsychiatric adverse effects, they do not cause brain damage. Chantix works on the nicotine receptors in the brain, and this is likely a source of some of the adverse effects. However, once the drug is out of your system, any problem is corrected, no damage done. Please don't ask for a study proving this. It is well know that agents (like anti-depressants) that work on neurotramsitters do not cause brain damage.

The report that on adverse events from May 2006 through December 2007including 227 reports of suicidal acts, thoughts or behaviors, 397 cases of possible psychosis and 525reports of hostility or aggression. Though about a thousand reports, these are not thousands of patients, and though these are all concerning outcomes, none of these have been confirmed to be due to Chantix and may have been due to simply stopping smoking. In addition, if you look at my numbers from my 6/25 response you will see that 1149 reports of possible adverse effects in 5 million patients is still a very low rate of events.

There is no "media campaign that advocates use of this drug" other than Pfizer's own promotion of its product. In fact, it seems like quite the opposite, which is why I am concerned. I think these reports are over-exaggerated in highlighted in the media, scaring people away from a safe and effective product, and leading them potentially to not quit. If you don't think this is an issue, please see the Forbes article today (link below) that shows that sales of nicotine replacement products have dropped, likely due to negative media regarding Chantix. This is sad, because about the same time as the reports came out, the surgeon general's update on smoking cessation guidelines was released (with no press at all) stating that ever patient interested in quitting should be offered medication, and that Chantix was the most effective agent.


http://www.forbes.com/healthcare/2008/06/26/glaxosmithkline-chantix-survey-markets-equity-cx_lal_0626markets20.html?feed=rss_business_healthcare

James Rowan said...

I'm sorry, I meant to add the word "know" to my sentence. I meant to say... I and thousands of others might have permanent brain damage, we just don't "know" yet. Sorry, hey, thanks for being as kind as you have been. I hope everything turns out best for both you and me. Just keep an open mind about this one, that's all I'm asking for. I promise I'll back off now, and let others have their say.

Shep said...

Mr. Rowan, Dr. Mintz, I admire the courtesy you extend to each other in your contentions. Meanwhile, day 2 & all is well. Cigarettes are still enjoyable. The crave and satisfaction are still there.Good dreams, but I always have had vivid r.e.m.'s
Carry on gents.

Anonymous said...

I have a question for the Doctor.
I am taking vidcon for back problems and lipor.Would I still be ok to take chantix.
Thanks

cornflakegirl said...

Hi Dr. Mintz. I wanted to say that I'm really happy to have found your blog! I just started taking Chantix today. I'm hopeful that this will be the aid to truly help me conquor smoking. I do have a serious question though. I have done quite a bit of reading about chantix, and it seems that most people have problems when drinking heavily while on chantix. (Like that guy who went ballistic on his girlfirend and his neighbor shot him) I am not a drinker, but I was wondering if you knew of the side effects of occasionally smoking pot while on chantix? Probably not a good idea, but I am curious :-) Thanks.

Dr. Matthew Mintz said...

Shep,
Hope you are still hanging in there.

Anonymous 6/28,
There are no known contraindications to taking Chantix with Lipitor or Vicodin.

Cornflakegirl,
Love the pseudonym and glad you like my blog. It is not clear that alcohol is connected to neuropsychiatric problems related to Chantix. Most reported instances happened in patients with current or prior histories depression, anxiety or other mental healt disorders. Many patients with these conditions self-medicate with both nicotine and alcohol. Thus, alcohol may have contributed to drastic events such as the one you mention, but probably not due to some interaction.
Regarding interactions with canabis, I obviously can not condone use of illicit substances. Although, as with alcohol, there is really no known mechanism of action for an interaction, any substances that alters your mental status should be used with caution when taking any medication that works with neurotransmitters in the brain. This is true of anti-depressants and anti-anxiety pills as well. Though the recently reported neuropsychiatric symptoms usally occured in patients with pre-existing conditions, unusual dreams were reported in some of the original studies, so there is more than a theoretical reason why canabis and Chantix should not really be taken together. But again, no known set of data suggesting this is definitively dangerous.

James R said...

Doctor, I have read thru your posts. I still have not heard your opinion on something. So.. I'll ask again. Doctor, why do you think non-smokers were kept out of drug trials concerning Chantix? thanks dude

Dr. Matthew Mintz said...

I do not believe they left out non-smokers, but the data is not in the public domain.
For a drug to get approved, it needs to be shown to be both safe and effective against placebo. (Wikipedia has a great explanation of this- search Clinical Trial). First, drugs are tested in animals. Next, they are usually tested in a few healthy humans first (Phase I) to make sure that are no side effects that weren't picked up in the animals. After that, they are tested in patients (Phase 2 and 3) to see if the drug actually works. All of the data is submitted to the FDA, but is usually only the Phase 2 and 3 gets published.

James R said...

Hi. I was wondering if this drug is being examined for use with other medical issues. If that's the case, should there be more trials, or should we go with what we have? Thanks for everything, I have learned alot, continue the great work.

Shep said...

Dr. Mintz,
Thanks for asking. Day 8 and I am smoking considerably less. A lessening of desire coupled c/ disciplined denial is noticeable. No adverse effects or altered states present.
This ole (smoking) dog is learning new tricks...

Anonymous said...

This drug was not tested on a realistic percent of the popultion. It stays in the malanin the longest. You do understand what that means as a doctor so I will not explain further. Maybe that is part of the dark side effects.

I assume you also know what chantix was based off of, cytisine which is a tobacco substitue. Yes it is an effective method but not an FDA approved one. No wonder nausea is one of the most common side effects as it is more toxic then nicotine when ingested before Pfizer made it more absorable.

I know someone who died from chantix due to one of the rare s/e. After having a bad w/d from chantix, I hate it and didn't like being duped into a deadlier addictive drug. Because I tell my story others have also looked into the reality that chantix causes what Pfizer says on the doctor's insert. I resent the doctor's for not warning me, for not paying attention to my report os s/e and mostly for abandoning me when I did have a serious s/e.

You mention a lot of Pfizer drugs including the one that made them big today, penicillin. Cytisine has been know as a safe drug for nicotine replacement since then too. Why is it "good news" that Pfizer made a drug with 165 s/e? How can use smokers prove it is chantix that caused our new health issues when you doctors control all the tests? Last question. Why is there no instructions for a "wean" off chantix?

Dr. Matthew Mintz said...

There is no perfectly safe drug. There is no drug that works all the time on every patient. There is no drug without any side effects. There will be some patients that take a medication that may have rare, but very serious side effects.
The question that patients want to know (in my experience) from their doctor is whether or not the risks of the medication are low and the benefit is likely. Using this criteria, I would argue that Chantix is a good medication. Randomized controlled trials (who does the studies is an entirely different issue- I would greatly welcome a government sponsored, independent trial on varenicline)show Chantix to be the most effective medication (pill or nicotine) for smoking cessation. The most common side effect (30% get it) is nausea, which is mild and usually goes away. As medications go, the side effect profile is pretty good. I have listed (above) the links to the side effects of Chantix, Viagra, and Zyterc (the fact that they are all Pfizer is merely a coincidence) for comparision. I would argue that Chantix is the safest of the three.
Any substance you put in your body, including pharmaceuticals, vitamins, herbal supplements, or even naturally occuring products (alcohol for example) can have serious side effects, especially if not used correctly, or used in the wrong patients (i.e pregnant woment with alcohol).
It is horrible that some people have very serious side effects from a medication. The question becomes how rare/serious vs. benefit of the medication in the majority of patients.
My problem with all the media attention surrounding Chantix is that it will scare patients away from taking a safe and effective drug. Are there side effects? Absolutely. Is cautioned warranted in certain patients? Yes, specifically those with mental health disorders. Should physicians warn patients about both common side effects, as well as rare but serious side effect? No question. Would I recommend Chantix to the majority of patients interested in quitting cigarettes, the leading preventable cause of death in the US? Without hesitation.

Anonymous said...

Dr Mintz
I am going to start taking Chantix tomorrow July 7th I have read all the information
About and will try it with an open mind.
But I have a question for you. My husband took Chantix for two weeks then stopped
And has been smoke free for 3weeks now problem is he has no energy I thought when you quite smoking you would have more energy well he has less then every Why.
He has always had mood swings at times but they seem to worst since he quite smoking
Is this normal for some people to have these problems when they stop smoking

Dr. Matthew Mintz said...

that's great that you are committing to quitting smoking.
Regarding your husband, Chantix or stopping Chantix should not cause lack of energy. A few things to consider:
1. Chantix is supposed to be used for 12 weeks. It may be possible to use it for less time, but that is the way it was studied. However, there is good reason to use it longer than 2 weeks, as it takes the body some time to get used to being off nicotine, and Chantix helps with these symptoms. Loss of energy can be one of those things.
2. People often use nicotine to treat stress of frank mental health disorders such as depression. If you husband had underlying depression that was being "treated" with nicotine, than his lack of energy could be due to depression.
3. Could also be something not related to either #1 or #2

I would recommend that he speak with his physician about various options.

Andrew said...

Dr. Mintz,

I appreciate your blog.

My wife and I have been using Chantix for three weeks. Before posting, I asked her, "Has Chantix made you feel weird?" She shook her head, and went back to brushing her teeth. She hasn't quit smoking entirely, but has gone to one cigarette (or less) a day from half a pack (or more) a day.

I was a heavier smoker, up to a pack a day. I smoke a fifth of that now on days I even smoke at all. I feel calmer than I have since I can remember, which I credit to not being loaded with stimulant. I also sleep better, likely for the same reason.

We both had vivid dreams at the beginning. Before starting Chantix I was very worried about the dreams -- however we felt like some bad dreams were better than a bad reality, the latter surely the result of continuing smoking.

Too bad we won't make the news!

Sincerely,

Andrew

Wizard said...

Dr. Mintz,

I have an appt with my Dr. on the 25th to discuss stop smoking options. I plan to discuss Chantix as a possible aid. I have read many blogs and articles about it and the effects. Other than my smoking, I believe myself to be a very healthy 54 yr old male. My annual physicals have always been normal and have never had a history of mental health issues. I am a bit concerned about all of the negative posts that I have been reading. I know that most of them are private individuals or organizations looking to "make a buck" on other products. Can you recommend a non-biased professional site that I can get more true and factual information besides the Pfizer site? I am basically looking for things that I need to discuss with my Dr. Also, what can you tell me about the withdrawal reactions to it when stopping? I have seen many things from people experiencing a wide range of problems once they stop taking it. Do these occur by simply stopping the treatment or even if you wean off of it?

Thanks

James R said...

Dr. Mintz, where are you?

Dr. Matthew Mintz said...

James,
I am still here, though I had to take a few days off. Though I try and respond to most comments on my various posts, I also try and post on new topics. My most recent post regarded several items in the news. I plan to post today or tomorrow about Avandia (another favorite topic).
Additionally, I am working on a way to give medical advice directly to interested parties online, but I am still working out the legalities and logistics of this. Hopefully more on this soon.

Anonymous said...

Why are you not answering some of the questions people are asking you Dr. Mintz? You have a good informational site but recently have not followed up on people's concerns.

What happened to Shep?

Anonymous said...

chantix 8 days now. No dreams ( bad one ). I sleep good. Slight headache. I was smoking 2 packs a day. Now I smoke 0. I do feel a little anxious, but that is more the withdrawal from nic.

Dr. Matthew Mintz said...

Annonymous 7/29 2:06 PM: glad you are tobacco free, glad no side effects. Hand in ther

Shep, if you are out there, let us know how you are doing

I try to respond to most post, but I can not respond to specific clinical concerns (i.e. give medical advice) in a public forum. There are liability and medicolegal issues. Rather, I try to respond to comments, and give general answers that will hopefully be applicable.
I am working on a format where readers of this blog will be able to ask me for specific medical advice, but this is not currently available.

Shep said...

Dr. Mintz et al,
Shep here at week 5.
What an amazingly miraculous experience I am having with my smoking cessation via mindset & Chantix. Zero to 3 smokes a day for the last 3 weeks.
Side effects are nil c/ the exception of the grin on my face.
Thanks for asking, to be continued...

James R said...

Good job Shep.
I hate to rain on everyone's parade, but a new study shows that the success rate for stopping smoking using Chantix is about the same as other stop smoking methods. I know, I know, I'm trying to keep others from trying the medicine, but I still firmly believe that stopping smoking is the best thing for every smoker. But...there is nothing wrong with having more trials, having more information, more debate, and most of all, more respect for those who have suffered. Regardless of all this, there is still a 50/50 shot that patients will have severe side effects; you might be ok...or you might want to claw your face off, literally

Dr. Matthew Mintz said...

That's great news Shep.
Keep up the good work.
James,
There is one recently published trial where Chantix did not perform as well as in previous trials, though it did do better in some areas then the other products.
I do agree that more trials are necessary.

Anonymous said...

I'm a 55 yo man and my partner is 50 and we've been together for 30 years. When we meet in 1978 he smoked and I didn't. He stopped smoking for several years at my behest but after several years he started up again and I started too! Age 31 and I began to smoke... how stupid was that. In Jan of this year we asked our Doctor about Chantix again. We asked him about Chantix when it first came out and he suggested we wait to see how it fared in general use over time. In Jan of this year he asked if we were still interested in quitting smoking and we were. It took Ron 5weeks and 1 day to fully stop his plus pack a day and it took me 5 weeks and 5 days to stop my nearly 2 packs a day. I had some nausea Ron didn't but we bot had great dreaming about 2 weeks into the program. It really works but you have to want to quit. We have friends, two girls with Chantix scripts they haven't filled for whatever reason and Ron's brother who smokes almost 3 packs a day who doesn't want to take Chantix because to quote him "I like smoking". We convinced another fried to try it. He's in his fifth week and says he's smoking about Half as much as before Chantix. He's married and his wife has never smoked and we're all rooting for him. Chantix has been given a really bad rap. Years ago I tried Zyban when it first came out and all I lost was my libido. My doctor says that's because Zyban is really akin to Wellbutrin and is an antidepressant. Loss of libido is a common side effect with certain classes of antidepressants. Finally let me repeat that Chantix does work, maybe not for all but at least try it. We all want you to live!
Kevin M of RI

Anonymous said...

I am also someone who suffered 4 seizures in one night all of which are linked to Chantix. I have had ongoing cognitive problems as well. I was an older student heading off to graduate school with a 3.7 average and can no longer spell half the time or recall what is needed to complete tasks. This is not acceptable! Yes, I would love to quit smoking but I would rather die a slow death than to have my entire future taken away from me because a medication was never studied properly.

James R said...

Anon. Hang in there. I took Chantix last Nov. and I had severe side effects after one week of starting it. The further away from last Nov., the better I feel. By the way, do not expect sympathy from too many people, at least honest sympathy. Just hang in there, I hope you see some improvement soon.

Anonymous said...

An update
I'm finishing week 4 of chantix and have not smoked for 3 weeks. The insomnia and dizziness are gone. It took the first 2 1/2 weeks to get thru the withdrawals. I'm going to finish off the 28 days and then end the chantix. I smoked for 45 years and it feels so good not to smoke.

Dr. Matthew Mintz said...

For those of you who continue to struggle with stopping cigarettes, keep up the good work (whether or not you use Chantix)

chantix said...

There are nicotine replacement therapies available in the market, namely, nicotine gums, lozenges, patches et al that can help you overcome nicotine addiction. You can try out these therapies according to the doctor’s suggestions but they fail to yield desired results, chantix is definitely there to help you quit smoking. For more information on chantix, visit http://www.chantixmagic.com/.

Anonymous said...

I feel the need to be another "success" story. Yes, I had side effects, some of which were a wee bit scary. However, I would rather have side effects than die of lung cancer!! Hooray for Chantix for helping me kick a deadly habit!

Anonymous said...

For those that would like to understand Chantix a little more. I will take a minute to explain what it is and how it came about. The scientist at Pfizer where put on this project in 1996 and after years of trying to find a drug to help they looked at Tabex which is made with a plant called the broom plant. which contains cytisine which is poisonous if ingested but causes hallucinations when smoked. Now you all might know this as peyote you know the spirit world drug smoked by the indians. now the Pfizer scientists looked at cytisine because it's very similar to nicotine and was also used in WWII to help soldiers stop smoking. But here is where things change. See Pfizer scientist didn't like cytisine because it does not cross the blood brain barrier very well. So they created a new molecule. Varenicline which was designed based off the structure of morphine by moving one nitrogen atom in the structure makes morphine no longer have it's effects but allows them to attach cytisine to it. Now they have a drug that has the effect of cytisine and uses morphines structure to cross the blood brain barrier easily. Now I could get into how cytisine effects the brain but that info is available everywhere now a days. But now after reading this post where the doctor is upset about the negative media on chantix and how it's getting a bad wrap and that there is no evidence that chantix is causing all these problems. I must also remind him that he needs to be honest to the people reading this blog about what the FDA's role in todays medicine really is. So I will remind him the FDA bases it's approval only on the documented information that Pfizer gives them. There is no proof that the info supplied is truely factual or that it has not been scewed for benifit of Pfizer's Chantix Sales. What they are finding out is that in Phase 2 & 3 of Chantix trial studies. they did not list all effects that happened but instead Pfizer took it apon themselves to only list the side effects they believed actually where linked with the drug's testing. Let me give you an example in Phase 3 there where 24 cardiac incidence's that occured but Pfizer only linked 2 of those to Chantix. So now they are looking into how that was determined. The FDA is coming under fire from many groups and politicans about there lack of saftey in the past few years. Is chantix a wonder drug? it's deffiently really cool in concept but with out more testing and longer term testing I think it is very dangerous based on the ammount of reported side effects now happening in Phase 4 trials. Which by the way Phase 4 studies for those that don't know is the post marketing study that happens based on people actually taking the drug and the adverse events that get reported to the FDA. Also we need to make clear that while yes bad media will get more people reporting there issues. We have to understand that the actual amount of people that do file adverse events with the FDA is a very small percentage of the actual number of people experiancing side effects. Pfizer has a really good stance in the issue because all they have to do is keep claiming there is no data that proves chantix is causing the issues. But I say this is easily solved because all Pfizer has to do is release the information proving that chantix isn't causing the issues. But they won't because the truth is what this drug is doing is beyond what our science is capable of understanding at this point in time. To many unknowns as to how this drug is effecting receptors that we do not fully understand yet.

Dr. Matthew Mintz said...

Thanks for your post. There is no question that we don't have all the information needed. I think we need to completely revamp the FDA's post-approval process and adverse events monitoring system. I would advocate combining the two, such that a newly approved medication could be prescribed, but only under close supervision where side effects were monitored. One a few hundred thousand patients had taken the drug safely, it could then be released to the public.
However, this system is not yet in place, so we need to rely on incomplete data. This is challenging for a practicing physician. On the one hand, smoking is the leading cause of preventable death and one of the most important things I can do for my patients is to help them quit smoking. On the other hand, a newly approved drug may have some side effects. Based on the limited data I have about the drug, it seems safe and effective for most patients, and likely the best option for many.
The problem with the media is that they focus on all that is bad and scary. If I recommend a prescription, and the media scares patients from taking it, this often does more harm then good.

Anonymous said...

I agree with you Dr. Mitz you have your work cut out for you when it comes to prescribing medication that has even the smallest chance of side effects in patients that you never thought would. I also agree that the FDA currently is not sufficent in there methods of approval. The media does only report the bad stuff in all stituations and then expect you to pay for commercials to highlight the positives. I have never been one to have faith in the media. I think Doctors do get bad raps when it comes to prescribing medications that turn out to produce side effects because they are only prescribing based on there limited info on said drug. Smoking is the worlds larges preventable possible disease creators. And so It is very important to reduce the number of smoking individuals just based on the huge number of smoking related deaths every year. 70% of the people who smoke say they want to quit so a drug that might help them has been long over due. Unfortunately large pharmacutical companies even though they say they research for the better health of the world. The truth lays in the large ammount of money they make on medications every years. So once the all mighty dollar gets involved large pharmicuticals tend to do things to avoid the red tape that might prolong the release of there drugs in order to hit the expected profit margins they projected. Chantix is a good example of this while it is a wonder drug for the world and soon will be marketed for all types of addiction including alcohol. When science stepped into this new world of focusing on brain receptors there just isn't enough research done in this area to create a drug that could have unexplained side effects. This is where I believe Pfizer and Chantix needs to be put under a microscope and studied more so then your average medication. Currently all research is only based on statistics. And so if you read every press release made by Pfizer concerning Chantix. They keep claiming that there is no proof that Chantix is causing these side effects and that it is very possible that nicotine withdrawl could be the culprit. But then when we look at statistics at how many people commit suicide from trying to quit smoking we see that the numbers don't match what is appearing in Chantix. Another interesting article for you Dr. Mintz is this one

http://www.emea.europa.eu/humandocs/PDFs/EPAR/champix/H-699-en6.pdf

This article is how the EMEA decided to approve Champix in europe pay attention to pages 35 and 36 which shows the side effects reported in Phase 2 and Phase 3 study's. Also keep your eye on the number of events vs what Pfizer thinks might be Chantix related. Now again we have no real explaination as to how Pfizer determines the difference. Another thing to pay attention to is that in the doctor hand out for chantix it does list all the side effects not just the ones that had the highest incident reports. Now if you compare this list with the side effects list of a Pituitary adenoma. We see a very concerning similarity. I'm not saying that Chantix causes tumors but what I am saying is that prescribing chantix you run the risk of your patient having symptoms the same as a pituitary tumor. Doesn't sound very fun. As time goes on and more study is done I think eventually Pfizer is going to loose control of the data and third party research firms are going to start getting there results back from there independent studies and this is when we will know how safe or dangerous chantix really is.

Aileen said...

Hi,
I was researching blogs for Chantix, when I came across this site.
My husband and I started taking Chantix together on October 20. Of course he did not start his until October 21 but he started. I'm in the middle of my third week with Chantix. I quit smoking on Oct 27. I did have a couple of slips on the weekend, where I smoked 2 cigarettes. The first week, the cigarettes started tasting nasty. On my quit day, which was a Monday, I did not have any nictotine withdrawls just the habit. I was ok during the day with not smoking. I did not even want to smoke. In the evening at home my urge to smoke was a little stronger. I wanted to have a smoke. I just said to myself "you do not want a cigeratte, it is a habit do something else." The urge went a way after about 5 minutes. These past couple of days, I noticed my sense of smell is alot stronger. Now I think cigarette smoke is just disgusting. I can easily identify the smokers by their smell.
The side effects I am having is minimal.
This past week, I have been having a hard time sleeping. I toss and turn alot at night. That is why I am tired during the day. Vivid dreams? Yes, I have them, but they are just weird. I think to myself, now why am I dreaming about that. The dreams are not scary or horrible. Sometimes they are just funny. My 4-5 diet sodas a day I use to drink are down to 1 a day if that. Which is regular soda. The diet sodas do not taste good anymore. I do not know why. I have been drinking more iced tea, fruit juice and water. Those are my side effects.
I still have a cough but not as bad as when I was smoking. I am hoping the cough will stop soon.
I decided for Week 4 pack, I am going to ween myself off Chantix. I am going to start taking 1 full pill in the morning and a half a pill at night and work my way to half a pill a day till gone. I believe I will be fine. I do not want to stop taking cold turkey and put my body in shock.
About my husband who is supposed to be quitting with me. Well, he is not doing as well. He is still smoking. Remember he was supposed to quit Oct 27-28! He is smoking alot less. He is down to half a pack from 2 packs a day. I tell him that he is just experiencing the habit not the nicotine withdrawl. He just needs to break the habit. He claims it is hard due to his line of work. He is a construction worker. My advice to him was air out and clean out his car. Do not let his coworkers smoke in the car at all, while driving or on break. I am not sure why he is having a hard time. I think deep down he does not want to quit but yet he does. He has a bad back and surgery to correct the problem. The surgeon will not do surgery until he is nicotine free for 2 weeks. I keep encouraging him and supporting him. He is going to try hypnosis on Nov 12. I am hoping the Chantix and hypnosis combined will work for him.
I will keep you posted on our updates.

runzwithknives said...

I agree with *everything* omnibus driver stated this drug(I am not on Cumadin however).

At a mere 100 pounds the 2 pill dose was too much and caused extreme drowsiness. My doc and I solved this by cutting the dose 25% and administering 1/2 pill 3x daily. Worked as well.

Yes I had some strange dreams...they were nothing and I mean nothing like the horrible nightmares with the patch. Some loose stools but that went away in a few days.

Big deal *shrugs*. It was nothing.

I can tell you this...the welbutrin...I had a full blown panic attack when I missed one dose.

My husband rear ended someone as well from being so spaced out on it.

My doc was straight up about the success rates. And that it seems to have greater success for woman than men. You have to keep at it too. It's not a one month miracle drug. Smoking is far, far more harmful.

Yep, each person can react differently...no matter what you are taking. Work with your doc.

runzwithknives said...

If I may
Aileen...have your husband stop everything he is doing for 10 seconds and ask himself this when he has the urge..Does my body want this cigarette? Hokey but I swear the answer...if he can be quiet for those ten seconds will be a resounding NO.
If he still has the urge and does skmoke...do nothing else but smoke the cigarette, Not talk, not walk, not drink, not drive. Do nothing whatsoever except smoke. Bet he gets through 1/2 of it and puts it out in part because the triggers (associated habits) are being eliminated.

You can do it and so can he!!

Anonymous said...

Just a follow-up on the Chantix program. As I wrote in Aug 08 on this blog, my partner and I started taking Chantix in Jan 08 and he stoped smoking on Feb 14 and I stoped on Feb 19 of 2008. I am happy to report on the 14'th of this month, the 19'th for me, we both have been smoke free for 9 full months. Chantix worked for both of us and thank God & Pfizer for it. The insurance companies should pay for it.
Kevin M. of RI

adelen said...

Chantix, the medicine manufactured by Pfizer Incl. is meant for triggering off smoking cessation and as it is an FDA approved quit smoking medicine, you can administer the anti-smoking drug without any hesitation and successfully get rid of nicotine addiction. However, significant chantix tidbits available at http://www.chantixmagic.com clarify that the medicine is meant to be taken only after getting hold of a Chantix prescription from the doctor.

Anonymous said...

I do not wish to scare anyone,
I smoked for 35 years The entire time I was sexually ravenous for sex to the point it was bothersome to my wife.
I quit smoking using Chantix and have been smoke free for 20 months and 2 days. I attribute my success to Chantix as I have tried to quit before. I took Chantix for only 8 weeks. I experienced the wild dreams but eventually started becoming forgetful so I quit gradually as directed and have been fine. The only problem is I have totally lost my desire for sex starting with stopping smoking. This Bothers me and is bothering my wife more than the previous hyper sex drive.
As I have read Chantix works by blocking the pleasure center of the brain convincing you that the craving for nicotine has already been satiated. This, I understand is the same pleasure center that controls or stimulates sex drive.
My wonder is, can Chantix cause any permanent effect or damage to this pleasure center? I have been off of Chantix for 18 months but the sex drive has not returned.

Anonymous said...

My husband had a seizure after taking Chantix. He hit a telephone pole and was in the trauma unit for
3 days. Our auto was a complete loss
He now cannot drive for six months because it is the law in our state ANYONE having a seizure must wait six months being seizure free before driving again. At the time we never connected the accident with the Chantix. Then two nights ago more seizures one after the other. I did research and found many people in the same boat. Please do not take this drug. We will see a attorney. E.H.

Brandon Campbell said...

Dude, this drug is as dangerous as they come, and trust when I say this. If you were suffering the side effects that I am now you would not say this is an equal ratio. I don't care if 1 out of a million suffers that is still a problem and I think it is phizers responsibility to find out what is causing this. Until they do, they need to take it off the market and do more tests. Don't get me wrong, had I not had the reaction I am having then I would have been all game for it. Hell I just want to die because I feel so bad. The doctors really have no clue what it has done to me and pretty much just give up on my situation. They all say I am sorry I can't find nothing wrong. So now 1 yr and 5 months later I am still damaged with no answers..

Anonymous said...

I am new to this blog, and you may not even be into this conversation anymore. However, I felt compelled to let you know about my experience with Chantix. Like the rest of you, I did the research. Of course you see the side effects, and wonder, "should I take this risk?". Then the right side of your brain kicks in and says, "What have you got to lose, dummy, you're already killing yourself by smoking, and the money you're wasting is ridiculous." Ok, so I made up my mind...I'm ready to quit. I talked to my doctor and we discussed the side effects in depth. Now I was really nervous, but what the heck, right? WOW!!! I am SO GLAD I followed my gut instinct and took the plunge with Chantix!!!! After only a week and a half I as smoke free!!!! Yes, I have the vivid dreams. Yes, some are kinda freaky, but some are just like, what was that all about? LOL!!! I love Pfizer for making this stop smoking aid and recommend it to everyone that wants to change their life and become a healthier non-smoking person. Health permitting of course. Thanks!!!!

Anonymous said...

I hope Dr. Mintz checks this site once in a while. I have a couple questions for him. First of all, I have 4 very close friends and/or relatives that have taken Chantix, and have quit smoking and/or chewing tobacco in a matter of only a few weeks, actually to my knowledge none of them even had to finish the script. Just about all of them had some wierd dreams, some nightmares, some just vivid, so I am deciding to give it a whirl. I have been chewing tobacco, ALOT of tobacco for 10 years, I am on 20mg a day prozac for depression, nothing terrible, just down and kinda sad much to often, especially when my life is going well. I am also on Suboxone 8mg, one half tablet twice a day. Safe to take chantix, or not???? Thanks in advance....

Dr. Matthew Mintz said...

I read all posts, but can not reply to all of them.
I am glad you want to quit tobacco. I can not give specific medical advice to you on a blog. I can tell you that if you are on Prozac and subutex, then if you quit tobacco, with or without Chantix, this should be done in consultation with a physician. Stopping smoking can cause exacerbations in depression, and this may happen with Chantix as well. There are no direct interactions with the subutext or prozac, so they are safe to use together, but understand that there is a risk for increase in depression, including suidcidal thoughts (again with Chantix or without). As far as vivid dreams, this is a known side effect with Chantix. However, dreams are usually not bad dreams, and most people who have them are not bothered significantly by them

Anonymous said...

okay so I am on day 3 and have noticed my cravings aren't as strong. I also noticed that i am not drinking as much coffee it just doesn't taste as good.
I am a little concerned that on day 4 I am supposed to take 1 chantix at night also since I take Ambien. The doctor and the pharmacy both assure me that this will be fine but I am still concerned. I feel a little foggy brained half way through the day but no serious side effects. I am concerned with being addicted to the chantix and if you have to be weened off since I know some people who are now addicted to the nicotine gum.

Dr. Matthew Mintz said...

Anonymous 5/20,
Congratulations on your commitment to quit. There are no known interactions between Ambien and Chantix. Chantix should be taken twice a day (12 hours apart) and Ambien before bed. If you want, you could take the second Chantix earlier in the evening (i.e. 7pm) and the ambien 20 minutes before you go to sleep.
Chantix is not known to be addictive, and because of it's mechanism of action, should not be. Nicotine replacement (NRT) like the patch or gum is much less addictive then cigarettes, but there are still some reports of patients who become addictied to these agents. Chantix works differently then NRT.

Marianne said...

Hey everyone!
My name is Marianne and I had a similar experience with Chantix as some of you(James and fellow Anonys). I started taking Chantix in January and initially found it helpful; however, I had a seizure while driving my car and I was severely injured and in the hospital for quite a while. Thankfully no one else was hurt. I am discussing my case with an attorney and whether Chantix caused my seizure. I would like to learn more from other people about their experience with Chantix.
Please feel free to email me directly at:
clarkmarianne50@gmail.com.
I'd really love to hear from those of you who experienced seizure after taking Chantix!
Thanks and all the Best,

Marianne

Anonymous said...

It just makes so much sense that a person who wants to quit smoking to get "healthier" then wants to commit suicide while on Chantix. (Insert sarcasm)
I had a nervous breakdown while on Chantix, I have never been hospitalized in my life, I also went three full weeks on Chantix with zero sleep which contributed to the breakdown, being on Chantix at the time I was in too much of a constant fog to realize it was the drug doing it, I also lost my sense of taste and smell for well over a year and my anxiety level has increased a hundred fold and this happened in 2006 and is still that way today, yes, it worked to quit smoking, but I ask, at what sacrifice to my brain? depression and anxiety are experienced by millions of people, last thing they need is a drug that makes that worse.

Anonymous said...

I have a question. Recently my boyfriends mother had a stroke, caused by a cerebral hemorage. She was in good health and in her mid-40s.
She had quit smoking a couple months ago and had been taking chantix for a few months. Has anyone heard anything about this medication causing blood clots/strokes? I mean we cant think of anything else that could have caused it. Unless she had residual effects from smoking.
-Thanks for your time.

Anonymous said...

Hi,
I've been smoke-free for 7wks now. I used Chantix and it worked for me. However I have had a foggy head every since day three of taking the drug. I've been off it for almost 3 wks and still am foggy most of the time except when I first wake-up (very clear then.
Have other people had this happen and well might it end?

Dr. Matthew Mintz said...

congratulations on quitting.
you can certainly get a "foggy head" from either stopping the cigarettes or from the medication. The medication does not stay in your system that long and it has not been shown to cause permanent damage, so it is unlikely that the medication is doing this. I have not heard of patients experiencing similar symptoms. If this persists, you should see your physician.

michael said...

Dear Dr. Mintz

I took chantix for a month and it did indeed help me quit smoking! The problem is that two weeks after stopping the chantix I had a black out while snowboarding. I hit my head pretty bad I guess. My friends took me to the ambulance on the mountain when they noticed I was acting very strange. The ambulance rushed me to Loma Linda hospital in CA. Upon arrival I went into 2 consecutive gran mal seizures. The docs had to to put me on life support for two days when I awoke I had no idea how I had arrived there. I was able to leave that day as I felt ok just a little shocked and confused. The docs put me on dilatin as a precaution for seizures. It's been 6 months now since the accident I am currently in Hamburg Germany with my fiance. I saw a neurologist in germ who suggested I lower my dilatin level as I was taking 500mg a day. Two weeks later after slowly lowering my level to 300mg a day I had another seizure. It seems that I have somehow developed epilepsy. There is no history of it in my family at all. I cant help but wonder if chantix has something to do with this. The doctors did every test you could imagine on me the first time I had the seizures and found nothing. But it just seems that I have developed epilepsy out of noowhere. I'm 23 years old and now have to look forward to taking dilatin for a long time(if not forever) and always being very cautious of where I am. I have to monitor my sleep and not drink or anything else of that nature. I was just wondering if this could be a result of the chantix I'm almost convinced that it is.

Anonymous said...

Medical insurances are saying you have to be tobacco free for 6 months to be allowed to select a non tobacco user on your insurance policy. If someone gets a prescription for Chantix, can an insurance company find that out and use that against you and say you have committed insurance fraud because you received and purchased a prescription from your doctor for Chantix and you claim for your insurance premiums that you are a non tobacco user?

Anonymous said...

To: anonymous April 23 2010 and to Dr MIntz

During the fall of 2008 I took chantix for a mouth and it was successful at helping me quit s.moking. However it changed my life for the worth. What initially started of as a occasional brain fog ( as described by anonymous April 23 2010) while in the medication has now turned into a permanent vertigo day in day out 2 years after stoping the medication and still counting. Every scans and blood work has came back negative pointing back to chantix. I have to take ADHD medication in order to make it through the day. And it's progressive. Dr Mintz have there been more report of this nature on this medication since? Is there a way to remediate? Anonymous April 23 2010 did your symptoms disappear or do you still experience it? My name is Derka and I can be reach directly at kdrtaho@gmail.com.

Dr. Matthew Mintz said...

Not sure that an insurance company could use a Chantix Rx against you to deny you a lower rate. That being said, based on my dealings with insurance companies, they will do ANYTHING to save themselves money.
Most updated information on Chantix has not revealed any new side effects, and the issues of suicidal ideation and other worsening of psychological disorders don't seem to be any worse with Chantix than other smoking cessation aids or smoking cessation itself. However, any medication, especially one that works on your brain, can cause any side effect.

brightstar101 said...

Dr.
I like your blog because you "facts" when you make a statement. I have a couple of questions. I have used chantix before and about to use it again(started back up again). When I used it before, it worked well. My skin and my white of my eyes turned yellow and I started acting bipolar. I don't have any mental illness as far as I know..lol. I also have to take xanex once in awhile for anxiety. Do you think I should give it another try??

Anonymous said...

Lisa June,21 2012 2:00 am.

I've been on chantix for three weeks now, the first week, the urge to smoke was going away. Its now three weeks on, I'm doing great! Had no side effects thank God. Its not easy for me when it comes to hanging with friends on weekends and drinking, that's when I want to smoke the most. And I did have two or three but the next day I don't want them anymore. I'm going to make it! With the help from Jehovah and chantix ill do great !!!!

Anonymous said...

Started taking my starter pack of Chantix. "Side effects' were not so bad on the starter dose (one quarter of dose once in morning. Bloated, weird dreams, waking up in middle of night, unable to sleep, tiredness during day. I can deal with these symptoms to quit smoking. On the fourth day, after taking my evening dose (up to one half dose) I noticed I started to get confused and it was more difficult to try and get a point across when I was speaking. Woke up in the morning, took my dose. As dose began to take effect, I noticed I was unable to focus on completing a task. Kept getting up and pacing, started to panic a bit about why I was pacing, started feeling a bit paranoid. Had to go to work, paranoia went away as the day went on but this episode scared me enough to get off this medicine immediately. I am not saying that everyone shouldn't take it...but be very, very cautious. This medicine is stronger than I had anticipated...I was still smoking as I was advised to do so by my dr so these side effects were not due to nicotine withdrawal (not enough of the champix had built up in my system, I was still enjoying smoking and not getting a gross taste). I asked a few people about their experience with chantix and mixed reports. I do think that blackouts and psychotic episodes most definitely could be linked to this drug... that's quite the risk to take...People managed to quit smoking before this drug came out...(note: I'm not manic depressive, and am a healthy 25 yr old female, currently not on any meds nor had taken any while starting chantix, side effects were completely out of the norm for me)

Anonymous said...

I tried Chantix a few years ago and had some pretty wicked side effects...the vivid nightmares, the foggy head, the inability to focus and speak properly and the depressed feelings of not wanting to live. I immediately stopped taking it after a few days and I never did stop smoking. I am a veteran and since then the VA has stopped dispensing this drug in their hospitals. It is too dangerous.

I'm glad they did that and I'm also glad that I stopped after a few days because with long term use the drug depletes serotonin levels in the brain causing permanent depression and other lifelong neurological disorders. The VA has verified this and that is enough to make me warn others that it's not worth it.

Anonymous said...

Doc, are there drug interactions with chantix and the following: ambien, xanax, prozac and lanictal? Please reply as I am starting it today. Thanks in advance.

Dr. Matthew Mintz said...

Yes. There are interactions, though this doesn't mean that you can't take Chantix with these meds. Please contact your prescribing physician and (as the TV ads say) tell them about all the medicines you are taking

CB said...

I am currently taking chantix for the second time, (first time I couldn't afford the pricey refill). The first week is a bit difficult, getting used to the mental changes, but its not as bad as some of the comments I have read on here. For me its a miracle drug. I have tried EVERYTHING available to quit smoking, even putting myself on lockdown. In my opinion, and I'm not a professional, it takes a higher degree of mental strength to endure the first week of this drug. I did suffer confusion and a sort of displaced feeling. For those of you wondering about interactions I'll tell you, I've taken xanax, clonipin, ativan and up to 60mg of Valium while taking chantix. I survived. No Ill effects. I disagree with the chantix bashers, I say take it if you can afford it.