Thanks to Craig Eubanks for drawing my attention to this story in the LA Times: Drug taken to stop smoking is linked to traffic mishaps.
I’ve previously written about how varenicline (the generic name of the drug sold as Chantix in the US and Champix in most other places) has been linked to psychological troubles including suicidal thoughts in those taking it (“Just say no to stop-smoking drugs“). The LA Times article highlights another danger of its use: it may cause drowsiness and even blackouts.
There is a warning in the material that comes with it, apparently, as well as on the Chantix website that you should “use caution driving or operating machinery until you know how quitting smoking and/or using CHANTIX may affect you”. (Those right there are weasel words. I have never heard of anyone having trouble driving as an effect of nicotine withdrawal, although trouble concentrating can be among the withdrawal symptoms.)
Varenicline is believed to work by blocking the access of nicotine to the receptors in the brain which allow it to stimulate the release of several brain chemicals, giving a feeling of reward that is also linked to motivation, learning and memory and at the same time sharpens attention and masks pain. (See How Stuff Works on nicotine in the brain.)
Because the varenicline is there, it blocks the access of the nicotine to the receptors, and the dopamine release that smokers are used to receiving from their cigarettes no longer occurs. Think of it as filling up the parking spaces that nicotine uses so it can’t get access any more.
Pfizer’s Chantix website contains some explanation in lay terms. Here’s a more technical explanation from the long and detailed page on Chantix at whyquit.com (an outspoken and opinionated advocacy site for quitting “cold turkey” without the use of drugs):
Varenicline is a partial agonist that produces up to 60% of the dopamine release generated by nicotine, while actually blocking nicotine molecules from occupying nicotinic acetylcholine receptors (the alpha 4, beta 2 subtype), thereby preventing nicotine from releasing dopamine.
So you are still getting your dopamine hit, just less of it, and via Pfizer instead of the tobacco company – raising the possibility of addiction to Chantix, as whyquit’s article goes on to discuss. Quite apart from the common side effects of “vivid, unusual or strange dreams” and insomnia, and the nasty gastrointestinal side effects.
Even if the quit rates that Pfizer claims for Chantix are accurate – and whyquit.com claims that they aren’t – is it really worth the risk of serious and uncomfortable side effects, side effects worse, in many cases, than the side effects of simply giving up smoking without drugs? (It is if you’re not going to be able to give up otherwise, since smoking is a lot worse for you than any of these side effects.)
I’m all for making use of whatever will help people give up smoking, all things being equal. As well as offering hypnotherapy, I educate my clients on factors that will help them give up and deal with any recovery symptoms and follow them up by phone at intervals. I’ve just booked in to take the National Heart Foundation’s cessation practitioner training (despite the fact that they’re in love with nicotine replacement therapy as the great stop-smoking secret of the ages), so that I’ll be as well-equipped as I can to help my clients stop poisoning themselves. But even if I was qualified to prescribe Chantix, I wouldn’t do so under any circumstances. It’s just not worth the substantial extra risk for the minimal and questionable benefits.
NOTE: Since taking the training course just mentioned, I’ve now moderated my anti-drug position as mentioned in my more recent post on Nicotine Replacement Therapy. I’d still be cautious about Champix and would still stress the importance of dealing with underlying issues, but almost anything is going to be healthier than continuing to smoke.
For more stop-smoking resources, take a look at my free ebook, How to Stop Smoking.
Technorati Tags: nicotine, Champix, Chantix, varenicline, smoking, smoking cessation, quitting smoking, stopping smoking, giving up smoking, drug alternatives, Pfizer
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