Is Anti-Smoking Medication Safe?

The Internet contains thousands of first-person accounts on the effects of anti-smoking medications. Many of them are positive and fine, while others are plain scary. We can imagine that some of the most scary ones maybe mischievous works of pure fantasy by ‘trollers’ while others could well be genuine accounts designed to warn others. There is no fool-proof way to decide which category any particular report belongs in. Bearing this cautionary note in mind, I reproduce here a few edited accounts that give pause to the use of medications to stop smoking. These 10 cases are not a random or representative sample, but are a minority of scary accounts that have the ring of truth, and should be considered before taking anti-smoking medications.

This set of cases must be considered as a non-randomised, non-controlled, anecdotal account of drug effects. Even if only one or two of them are actually genuine, there would be major cause for concern for any doctor or smoker thinking about their use.

CASE 1:
“This Is My Brain on Chantix…After a few weeks on Chantix, I had managed to stop smoking altogether—but it didn’t feel like a triumphant turn of events. I’d become rather reclusive, avoiding calls from friends, and basically just shuttling back and forth between my office and my apartment. I began to dread six o’clock; it meant I had to walk through the streets again. The subway was now out of the question; it made me too nervous. I stopped going to the gym, too.
I wondered whether Chantix was zapping my brain’s pleasure-delivery system to such a degree that not only did I find no reward in cigarettes, but I also found no reward in socializing, exercising, writing, or any of my usual self-stimulating tricks. I’d pace the floor, sit on the bed, channel surf, pace some more, try to read, but the room had a stale, sinking feeling. Maybe I should go and grab a drink—then at least I might be able to get some rest.
There was no warning against drinking while on Chantix, and even if there had been, I can’t say with any honesty that I’d have adhered to it. (I wasn’t taking any other medication, though.) But while I’ve had my fair share of dark and drunken nights over the years, what I experienced on Chantix was something else altogether. One evening, I steeled myself to go on a date, but after a few drinks with the guy, I abruptly burst into tears mid-sentence. The crying jag lasted about 30 minutes, with the thought I can’t do this anymore looping through my head. This was happening a lot lately, as though someone had spliced other people’s thoughts into the tape whirl of my brain.
Another night, at an East Village bar, an older man in a trench coat caught my attention. I chatted him up for a while, until I realized I was actually trying to go home with the shadow cast by a potted plant. With alcohol in my system, I was somehow able to take this hallucination in stride: “The man who got away … ” But that same evening ended with my taunting a skinhead who was improbably on the corner of Avenue A and 14th Street. “You must be lost,” I snapped. “Are you looking for 1993?” He ended up chasing me into a deli and saying he was going to murder me. (The guy at the register called the cops and the skinhead fled, so I’m fairly confident that he, at least, was real.)”
(http://nymag.com/news/features/43892/index3.html#comments)

CASE 2:
“Chantix (or champix in Australia ) was the beginning of a total nightmare, I had a full mental and physical checkup and got the all clear. A great sign for a 40 plus man who smoked from 15. However I’m not a total fool and knew smoking would catch up eventually , so I decided to quit smoking and was told about the new wonder drug Champix… I had disassociate feelings that lasted for months after stopping Champix. Panic attacks and anxiety that have not stopped in years.. Even tried smoking again to see if back-tracking to the start would help… And guess what…. nothing helped… not even after being admitted to hospital and trying in vain to make the Doctor believe that Champix was the cause. So please please please don’t take this LIFE DESTROYING DRUG. Quit cold turkey it the best way… I took this in 1997 and its now 2013 and still suffer most days.”
(http://nymag.com/news/features/43892/index3.html#comments)

CASE 3:
“My boyfriend took Chantix for six weeks and quit smoking. It’s been two years since then and he had never been the same since. He’s depressed, angry and mean. He has anxiety. Isolates himself. Has rage. Lost all his friends and our two year relationship that was blissful. I don’t recognize him. He has been on depression medication for a year and is only getting worse. He went from an easy going man who never even said damn in bad traffic to a raging mean isolated sad nervous rageful man. It ruined his life and our future. But he still doesn’t smoke. What a nightmare. He doesn’t enjoy anything he once did-friends, camping, sex etc. He is an empty shell of the man I once knew.”
(http://nymag.com/news/features/43892/index3.html#comments)

CASE 4:
“…I’ve been thinking about going on Chantix for a while. I’ve cut down to about 6 cigarettes a day on my own, but it seems like I need a little boost to make me quit altogether. I asked my doctor if Chantix was safe for people with seizures, he told me to ask my neurologist. I asked the neuro and he told me to ask the pharmacist. I asked the pharmacist and he told me to ask my doctor. The waking dreams seem a little too much like the type of seizures and auras I have, which is a feeling I don’t enjoy.”
(http://nymag.com/news/features/43892/index3.html#comments)

CASE 5:
“In 2008 or 2009 (when I started Chantix), it was a health insurance promotion for Microsoft employees that wanted to quit smoking. So I participated, and was prescribed to me to quit smoking.
How has this affected my life? Well, I lost my wife of (25 years), I lost a wonderful job at Microsoft of 9 years, I had extremely troubling nightmares, that still haunt me today. I was almost hospitalized for severe depression, because my parents were extremely worried about my safety. We got all the way to the point where I had to sign the release form at the mental inpatient hospital, and I got scared and said no, we left.
Ever since then I have been unemployable, I lost my wife, I lost my relationship with my 25 year old son, I am losing my house, I’m 46 and living in parents basement, while I work with physiatrists to stabilize my severe depression. I’m on state DSHS health care.
The hardest thing for me is that I lost the love of my life. And caused her so much pain do to my behavior after/during I was prescribed Chantix, that she is scared of me, and for me. So much so, she asked me to move out then changed the locks on our house. This is the woman I spent 28 of my 46 years with and raised a son. Chantix is one of the most dangerous drugs that can be legally obtainable. It ruins lives! I have no life now. Thanks Chantix.”
(http://nymag.com/news/features/43892/index3.html#comments)

CASE 6:
“I took Wellbutrin several years ago and just started again about a month ago. I too blacked out on this drug after a night of dinner and drinks with a friend. We went our separate ways and then I blacked out… in NYC mind you. Somehow made it home, broke my elevator key in the lock, had no phone and my fiance was out of town. Somehow managed to reach a friend with a key, he rescued me and put me to bed. I have a vague memory of being in the elevator but nothing else. I thought I had been slipped a ruffie at a bar. Have had a few drinks with it this time around and have felt very hungover after 3 glasses of wine, which I can normally handle. Will definitely have to reconsider the alcohol after reading this forum. Thanks for sharing.
(https://www.drugs.com/answers/wellbutrin-drinking-681606.html?page=2)

CASE 7:
“The treatment (150 mg Wellbutrin) was effective in reducing my “appetite” for smoking. It also reduced my appetite for everything, including food. Therefore, at first, I did manage to stop smoking WITHOUT gaining weight or being depressed about giving up the cigarettes. It just didn’t seem important.
After a while, I began to notice that NOTHING seemed important to me. I also seemed to be moving in a world that had slowed down considerably. That may sound good, at first, but the reality was that the only thing that had slowed down was ME–the rest of the world kept going as usual. I began to notice that I couldn’t seem to develop a sense of urgency even when it was IMPORTANT to do so because I had lost my sense of “timing.” I tended to be late everywhere I went, I couldn’t complete assignments on time, and my sleeping time increased dramatically.
I was taking the Bupropion as an aide to break my smoking habit. I was also using prescription nicotine patches in decreasing amounts. The treatment WAS effective in TEMPORARILY breaking the smoking habit and possibly could have had longer lasting effects, however, my skin had a reaction to the patches (I started developing large, red, hot circles everywhere they touched my skin) and I found that I could not effectively lead my day-to-day life while under the influence of the Bupropion. Once I stopped using both products, I slowly returned to smoking.”
(http://www.druglib.com/ratingsreviews/wellbutrin/)

CASE 8:
“My hair started falling out after the first week. During week two, I saw my doctor and told her about this. She said it was not a known side effect. Internet research assured me the hair loss was not coincidental; others had the same reaction. I quit taking it a few days later.”
(http://www.druglib.com/ratingsreviews/wellbutrin/)

CASE 9:
“Day 1 was ok but day 2 started feeling panicked and racing with panic attack and day 3 I put the pieces together with even worse panic attacks …. I gotta quit taking this now today! I have no desire or craving at all for a cigarette but the freakishly scary panic attacks, especially when leaving my home are not worth it…..got to go cold turkey from here on out!”
(https://www.drugs.com/comments/bupropion/for-smoking-cessation.html)

CASE 10:

“I started taking this 9 days ago. The first few days was ok, I was kinda snappy, but ok. After day 7 I stopped smoking, didn’t find it hard to quit, but did have the worst panic attack while driving home, and called my husband and cried for the next 25 minutes. The next day I was ok, but today I was on my way to work. I was 5 mins down the road from my house and turned around. I had to call out of work. I cried and had a huge panic attack. It happened all throughout the day. Called the Dr. She said to stop taking it. It’s OK for quitting smoking for me, but the side affects are not worth it (aside from the sex).”
(https://www.drugs.com/comments/bupropion/for-smoking-cessation.html)

Judging from the cases above, reports of black-outs, depression, suicide, loss of memory, panic attacks, hallucinations, bizarre behaviours, the media reports of lawsuits, and also the findings of the scientific trial by Anthenelli and colleagues, using buproprion or varenicline to stop smoking would have to be your last resort. If absolutely everything else failed, you could consider taking one of them. But, personally, I would never do so, never in a million years.

The FDA released a video in 2008 linking Chantix to risk of suicide, but later withdrew the video.

 

Conclusions
1) Case studies suggest that medication in the form of Varenicline may be unsafe. Any smoker can ask whether he/she wishes to rely on a drug that has a chance of causing nausea, sleepless nights, bad dreams and, perhaps, worse.
2) Smokers will be able to reach your own conclusions. My personal recommendation is to steer clear of anti-smoking medications.
3) A better solution is to stop on your own initiative like millions of others or to use a Psychological Therapy such as a specially designed form of CBT and Mindfulness.
4) Your main objective in stopping smoking should be to clear your body of nicotine and any other toxic chemical. You can learn to reset to a more healthy and sustainable level of  homeostatic equilibrium.

 

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