This Is Your Brain On Chantix?

NY Magazine has published a interesting personal account from a patient who was taking the smoking-cessation drug Chantix. The FDA has reported 37 suicides and more than 400 reports of suicidal behavior in connection with Chantix, a pleasure blocking drug that sits in the nicotine receptors and prevents the smoker from properly experiencing their nicotine high. The FDA recently issued a patient advisory about the drug, requesting that patients carefully monitor their moods. The possible side-effects of Chantix now include “anxiety, nervousness, tension, depressed mood, unusual behaviors and thinking about or attempting suicide.”

The NY Magazine article contains some pretty freaky stuff. It seems that, for some people, taking Chantix turns everyday life into a David Lynch movie. The FDA says “vivid, unusual, or strange dreams may occur while taking Chantix.” The problem, it seems, is that for some people… these dreams don’t just happen while you’re asleep.

The next night, I nodded off listening to Radiohead’s In Rainbows, feeling a little guilty that I’d paid zero dollars for it. I had a quick blip of a dream: A dark, inky fluid was jolting violently from the corners of my ceiling, zigzagging its way across the walls and wooden floor in jerky sync to the music.

It was only a dream, though it seemed more immediate and visceral than my usual fare, which I rarely remember after waking up. The following night, things got even stranger. I fell asleep with Bravo blaring on my TV and dreamed that a red-faced Tim Gunn was pushing me against the wall. “But I always thought you were so nice,” I said.

By night four, my dreams began to take on characteristics of a David Cronenberg movie. Every time I’d drift off, I’d dream that an invisible, malevolent entity was emanating from my air conditioner, which seemed to be rattling even more than usual. I’d nap for twenty minutes or so before bolting awake with an involuntary gasp. I had the uneasy sense that I wasn’t alone.

I smoked a cigarette, then tried going back to sleep. But each time I started napping, I’d dream that something increasingly ominous–carbon monoxide? Vampires?–was sucking vital essence out of me. Soon the clock on my desk read 3:20 a.m.

The most unsettling thing about sleeping on Chantix is that I never felt like I was truly asleep. Some part of me remained on guard. It was more like lucid dreaming, what I thought it might feel like to be hypnotized. And it didn’t entirely go away come morning. As I showered, shaved, and scrambled into clothes, I tried to shake a weird, paranoid sense that I’d just been psychically raped by a household appliance.

It did help him quit smoking, though.. until he started hallucinating and smashed up his entire apartment. Time to try the patch.

FDA Issues Public Health Advisory on Chantix [FDA]
This Is My Brain on Chantix [NYmag]

Comments

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  1. brent_w says:

    Wow, thats pretty messed up.

  2. UpsetPanda says:

    One, it’d be pretty awesome to be in a David Lynch movie.

    Two, those are some seriously messed up side effects.

    Three, if you’re going to try to quit smoking, try the patch or the gum or rubber band slapping your wrist every time you think about nicotine. Pills should be the last of your options, and it looks like this isn’t a good trade-off.

  3. Trai_Dep says:

    Needs to be a law for any Big Pharma company that does direct-to-consumer ads for products that do bizarre things to behavior/mood: Execs electroshocked, assets stripped, corporate charter ripped up and their children sold to Southern Republicans.

    For starters.

    Seriously, anything that has such a complicated risks/benefit curve barely has a place in the market (if that), and certainly not something that should be portrayed in warm, cuddly ads pitched to laymen.

    Albien (or whatever that sleep-eating/walking/f*cking drug is called) and Chantix are the poster children for this.

  4. meeroom says:

    Chantix helped my mom (2 pack a day smoker) quit smoking. She’s smoked since she was 15 and has tried to quit several times with no success. She had some wacky dreams and that’s it. Anyone who has had a serious nicotine habit understands how amazing that is. Any drug you take can be dangerous, including over the counter stuff. The important thing is to be intelligent about it and aware of your personal reactions to anything.

  5. Ex_EA_Slave says:

    I’m getting ready to start Chantix. Personally, I can’t wait for some cool dreams. Better living through chemistry I always say.

  6. kittenfoo says:

    my sweetie was able to quit using the lozenges. and he’s both a 12-stepper and a pisces, so it is definitely possible to do it without chantix. that’s scary stuff.

  7. MercuryPDX says:

    That is one effed up article. I’m going to follow its advice and wait for the inevitable “additional side effects” discoveries.

  8. MercuryPDX says:
  9. Radoman says:

    Quitting smoking is a great idea to live a happier healthier life. Cartoon fantasies of your own suicide sound like a pretty freakin serious side effect though. I think what’s worse is that it wasn’t even part of the warning label at first.

    I don’t want them to stop selling it or anything, just disclose the true risks involved. We’ll never know how widespread the suicidal tendencies are if people don’t even know to look for them.

  10. Laffy Daffy says:

    Isn’t Chantix some sort of anti-depressant? I thought most anti-depressants worked that way — you feel lousy and depressed for several days until everything kicks in and balances out your brain chemistry. I was on Zyban but couldn’t take it (felt like I was on speed the whole time) and bailed. I quit for good after seeing Yefim Shubentsov, the “Russian eraser” in Brookline, Mass. Best $65 I ever spent. That guy is a god.

  11. levenhopper says:

    So how long until the class-action suit begins?

  12. rockergal says:

    personally I loved chantix. It made quiting soo freaking easy! I did have dreams but nothing weird. Like watching your dreams in High Def. I did feel a little down while I was on it but thats it.
    They did mention that extreme side effects are possible with people that already don’t know how to cope with real life.

  13. aloe vera says:

    My husband used Chantix to quit smoking right before our daughter was born. Sure, it gave him the shits and he only used it for a week, but it worked! Nearly 8 months later he reports no desire to smoke.

  14. PølάrβǽЯ says:

    I am all for FDA regulation of drugs and the bitch-slapping of big-pharma execs who push dangerous drugs that usually don’t even do what they claim. That said, consider taking the drug vs not taking it:

    If you take it, you may have whacky dreams and may become depressed and even suicidal (so have a trusted friend/family member monitor you to make sure you’re ok);

    If you don’t take it, you WILL die a slow and painful death from cancer.

    The drug may be dangerous, but so is lung cancer folks.

  15. clevershark says:

    Actually that description sounds like the first week of quitting using only the patch.

  16. nidolke says:

    I’d love to have some dreams like that, sounds fun!

  17. Yoni K says:

    @Ex_EA_Slave: Sorry… you’re going to be disappointed. I’m on my 3rd week of Chantix and the dreams are slightly more vivid than normal, but nothing too entertaining.
    If you want vivid, interesting dreams, try sleeping with the Nicotine patch on. I’d wake up every morning thoroughly amused.
    As for the whole quitting smoking… so far so good. Best part is, if you relapse, it won’t taste any good and you won’t get any rush from it.

  18. dreamcatcher2 says:

    @Trai_Dep: As long as the (horrific) side effects are disclosed properly, I don’t see a problem with providing dangerous drugs. I have an uncle who tried to quit smoking for 20 years, and it’s not as though he’s lazy or incompetent, he just couldn’t do it. Sometimes a little messing around with the brain chemistry is necessary (he eventually quit smoking thanks to a clinical trial of a new smoking-cessation drug). They key is making sure consumers are aware of the potential side effects, so they can make a rational decision and monitor the effects afterwards.

  19. Midwest_Product says:

    Chantix, a pleasure blocking drug that sits in the nicotine receptors and prevents the smoker from properly experiencing their nicotine high.

    That’s not a very accurate description of how the drug works, though. Nicotine acts by binding to a specific class of acetylcholine receptors in the brain (acetylcholine is a very common neurotransmitter). There are no “nicotine receptors” in the brain; just receptors for acetylcholine that nicotine hijacks. Varenicline, the active ingredient in Chantix, binds to those same receptors, which partially activates them (reducing cravings) but it also prevents both nicotine AND acetylcholine from binding to said receptors. This means that yes, Chantix *can* prevent nicotine from having an effect, but it also prevents the normal, non-nicotine-related action of those receptors (which are, unsurprisingly, related to the experience of pleasure). So neurological effects are an inevitable result of using the drug. I’ll be appalled if a class-action suit comes out of this, because it is physicians, not Pfizer, who have been misleading patients by claiming there are no side-effects.

  20. tande says:

    Even the patch and gum list vivid dreams as possible side effects. I never experianced any when I was using the gum but they did get kind of weird with the patch. I would of described those as HD dreams too. I had a friend that stopped using the patch because of the dreams.

    When my dad quit he used Zyban and he says it messed him up to this day. Part of the trick that he was supposed to do was think of a control word or number that had nothing to do with smoking when ever the urge to smoke kicked in. After awhile the word became associated with the feeling and not the urge to smoke so you stop smoking. Except now he just finds the whole thing anoying/amusing. He’ll be sitting on the couch reading or watching TV and he’ll kind of chuckle so we’ll ask him what was funny and he’ll say that the number popped in his head. Thats years after he stopped taking the zyban.

  21. I don’t mean to sound cavalier, but it is possible that the depression and anxiety are related to the smoking cessation and nicotine withdrawal, rather than the drug?

    As to liability: The docs write the scripts, Big Pharma tells the docs it’s safe, while dropping off samples and pens and clocks and mousepads and whatever else is in their bag of promos. Shared liability, but the bigger share on Big Pharma, since a GP doesn’t have the resources to run their own clinical trial.

  22. ekthesy says:

    I quit smoking weed (after a nine-year daily habit) about a month ago, and I have had the most vivid dreams ever since. I might add it was cold turkey.

  23. clevershark says:

    I quit smoking twice, for about a year each time, but by the end of both those smoke-free years I had become so anxious that I was practically useless at work. All day you just feel like something terrible is going to happen, but the anxiety is preventing you from doing anything complex or long-lasting, and you can’t keep your mind on anything for more than a couple of minutes. For some reason I can’t identify the anxiety went away when I lit up again (even though that first cigarette almost made me gag).

    I still don’t know what ingredient is responsible for switching off the anxiety. It’s not nicotine though, I tried resuming patches and those had no effect. Only actually smoking made me productive again.

    So yes, smokes may end up killing me, but it’s better than a long life haunted by obsessive thoughts about jumping in front of a subway train every morning when going to work because you think that’ll at least remove the sense of impending doom that’s constantly with you.

  24. topgun says:

    I used Chantix and it worked. I will say I had some of the strangest dreams, which was actually pretty cool. None of the bad stuff like nervousness, paranoia, suicidal thoughts.

  25. halloweenjack says:

    What would be even better is if you could pick the David Lynch movie, or even a specific scene. If I could be in the scene from Mulholland Drive with the two hot chicks going at it, I’d take up smoking just to get on Chantix.

  26. gemio says:

    @UPSETPANDA – it’s obvious you’ve never tried to quit smoking. c’mon now.

    I have been on chantix for 6 weeks now – after many nights of crazy dreams and reading all of the crazy things that have happened to other patients I went down to one pill a day, and that seems to have quelled the dreams. I wake up during the night now randomly, but not any worse than before. I slip up every now and then – I have smoked 2 cigs since starting chantix, but all the side effects seem to be much less prevalent since I went down to 1 pill a day. As long as you do not have a history of mental issues – this pill works great!

  27. dripdrop says:

    I have a question for those who have taken/are taking Chantix: How long do you have to use it until you no longer feel the need to smoke? Is it the case that you’ll have to keep taking it every day to stave of cravings?

    I’m asking because I would love for my mom to quit smoking and am curious about it.

  28. Rectilinear Propagation says:

    …Chantix, a pleasure blocking drug…

    Is it just me or shouldn’t they have anticipated it might lead to suicidal thoughts if it prevents your brain from letting you feel pleasure? Like Midwest_Product said, it isn’t just stopping the nicotine here.

  29. JDAC says:

    This is surely the same with any medication? One mans meat is another mans poison (or something like that). I had a few interesting dreams and a bit of an upset stomach, but others will not fare as well.

    Chantix/Champix worked for me, and my wife. I’m 5 days away from my 6 months quit and the idea of smoking now repulses me. Just as it did while I was on the Chantix.

    @dripdrop: I took it for the full three months, although I didn’t take the recommended 2-a-day for the last month. My cravings stopped after 10 days. In fact, my last pack lasted me 3 days (11 one day, 6 the next, 3 the last).

  30. bohemian says:

    My hubby used Chantix. He has been trying to quit for 15 years. He started taking it around the same time a bunch of his co-workers were doing the same so he had some forewarning about he crazy dreams. His doctor didn’t tell him anything about the side effects, neither did the pharmacy. So his only notification other than the fine print on the packaging was other people who have taken it.

    The first two weeks he said he had the really odd dreams and it was hard for him to sleep. After that it got better. He did need to stay on it for the full run of the packages plus another 30 days before he felt he could go it on his own.

    After the first month he was coughing up all sorts of nasty stuff for months. The only thing he said that would cut it was lemon drops.

  31. Yoni K says:

    @dripdrop: They suggest you quit at the 8 day point when the dose is upped to 2mg/day.
    I stopped around day 10-11, but by that point I couldn’t finish a cigarette, I didn’t enjoy them as much, and sometimes started gagging.
    I’ve cheated a few times since I quit, but they’re just not enjoyable.

  32. emptydarkone says:

    This is my second go with Chantix. The first time I lasted 2 weeks and went back to smoking. Wasn’t really ready yet. This time it’s been a week so far, and I’ve only smoked one pack of cigarettes. It seems to help knowing that if I really need one it’s available. It has helped to cut down especially if I don’t allow myself to smoke in the house.
    As for the dreams, they are friggin’ awesome! That’s where I get most of my pleasure. Haven’t had any type of nightmares. All dreams have been good and left me with a nice feeling for most of the day. YMMV

  33. Jon Parker says:

    The Commit lozenges worked great for me, and I haven’t slashed my wrists yet.

  34. gemio says:

    @dripdrop – you will always have the psychological cravings, the physical ones go away after the second week- agreed that after the 8th day, cigs taste terrible and make you nauseous.

    But most importantly, your mom needs to want to quit – for herself. You are not going to make her. If she’s not ready, she’ll fail.

  35. MaliBoo Radley says:

    My husband and I both quit 14 year, pack a day habits using Chantix. I don’t think either one of use had anything more than some dreams that were a bit more memorable in the morning. We’ve been quit for over 5 months now. It’s fantastic! I recommend it to anyone who has not had success with the more traditional products (gum, patches etc). Just remember, it’s a prescription medicine, don’t take it lightly. Ask questions and know what you’re getting into. I mean, you should be doing that with ANY medication.

  36. MaliBoo Radley says:

    Just noticed that my husband actually commented here too … Hi JDAC!!

  37. timsgm1418 says:

    have to disagree with this one, not all smokers die from lung cancer or even get lung cancer. Yes there is a higher percentage of lung cancer among smokers, but it’s definitely not 100% Not trying to make an excuse to smoke, but saying you WILL die from lung cancer is incorrect@aaron8301:

  38. Annika-Lux says:

    Here’s some Chantix to help you quit smoking, and here’s some Xanax and Zoloft to deal with the anxiety and depression you’re going to feel as a result of the Chantix. And here’s some Ambien; enjoy a slight trip before drifting off into dreamland for a ridiculously long time.

  39. dlynch says:

    say what you will – it’s been three months, six days, 8 hours, 1 minute and 36 seconds since i quit. 2950 cigarettes not smoked, saving $531.00.

    i didn’t notice any significant mood change – i was generally pissed that i wasn’t smoking any more, but it was a pretty low-key quitting process. i was an extremely dedicated smoker and was terrified about the prospects of quitting – chantix made it a breeze. it messed with my sleep, so i only took it once a day instead of twice, and stopped taking it as soon as i was able (about 6 weeks instead of 12). how hard is that?

    smokers are obviously a different breed to begin with – more likely to be heavy drinkers and/or drug users, and more prone to addictive personalities. is it any surprise that they’re, as a group, less stable than average?

    big tobacco is trying hard to keep people afraid to quit – not that big pharma is any less evil, but at least the chantix didn’t require another drug to wean me back to square….

  40. Abbott says:

    Everyone ought to read Alan Carr’s “Easy Way to Stop Smoking.” It’s totally sensible, and it has a clear and EFFECTIVE philosophy. He’s more well-known in the UK, where he’s from. Seriously, if you are smoking, please check this book out from the library (or buy it). It worked for me. And it’s free (just patches and gum are expensive as hell IMO.)

    I don’t think smokers have more “addictive personalities” than others. It just happens that they smoked a cigarette or two, and cigarettes are addictive! The flaw is with the cigarettes, not you or your chemistry.

    This pill, to me, seems to suggest there’s no way you can quit without expensive meds. Keeping people afraid to quit indeed! Same with patch, gum, etc advertising.

    I can’t emphasize enough how perfect and wonderful the Alan Carr book is. I have been a non-smoker for five weeks thanks to him and I have never felt better or more confident.

  41. the lesser of two weevils says:

    @PotKettleBlack: I was thinking the same thing in regards to the symptoms being more related to stopping smoking than to the drug itself.

    However there are lots of drugs where increased risk of suicide is listed as a possible, albeit rare, side effect, and not just psychological drugs. When I was a teen I took Accutane to clear my skin up and it was later found to be related to teen suicide.

    As for the vivid dreaming, many psychological drugs cause that same side effect. I wonder how much Chantix has in common with them.

  42. skeleem_skalarm says:

    People have got to watch out for this stuff. In 1994, I took a well-known medication that later was prescribed to help smokers quit. Seizures were a known side-effect, and I ended up being one of the unlucky ones. Prior to taking the drug, I’d never had a seizure, and nobody in my family had them. Later, a doctor who didn’t know my history with the medication asked me if I wanted to take it to help me stop smoking – I had to laugh. With most meds, when you stop them, you stop the side-effect, but I am on seizure meds to this day.

  43. Yoni K says:

    @Abbott: At $30 for a month of Chantix (insurance co-pay), it is actually cheaper for me than the patch… which, if I recall, was around $40 for 2 weeks.
    …not to mention $35/week if you smoke 1 pack a day.

  44. accessmemorex says:

    I Just found my new drug!

  45. Aphex242 says:

    Bah I took it and quit a two pack a day habit (that was 14 years old) over a year ago. I didn’t have any of this crap. At all. In fact, I had tried the patch in the past and found that sleeping with the patch gave me way weirder dreams.

    The patch is crap, I tried it numerous times with no result. Lozenges, gum… it’s all the same. You are basically trying to quit smoking while still being hooked on nicotine, then you try and manage your nicotine level into oblivion. Good luck with that.

    Chantix worked. Well. It worked the first time and I haven’t smoked since. It hasn’t been easy, but it really hasn’t been hard either.

  46. Azazel024 says:

    I am taking Chantix I am on my 6th day and I have had none of the side affects, I sleep well. No suicidal thoughts, the only thing that I have noticed is I get very very angry. I am a very laid back relaxed person and have never been like this before. After a couple of deep breaths I am usually fine.

  47. banmojo says:

    @Midwest_Product: I call bullshit on you. I know plenty of MDs who Rx Chantix, and they ALL tell their pts that it may have side effects. In fact, due to this recent report they are starting to give their pts printed info, and require them to sign a paper saying that they read the info and understand the potential risks. Guess what? These MDs could STILL be sued, because that’s how fucked up our system currently is. Don’t blame the MDs, dude, you don’t know what you’re talking about. (and if your personal experience has been negative with MDs so far, I’m sorry for you, but don’t go blogging like you know the practice of 100% of the MDs out there, because you don’t.)

  48. caffine61 says:

    For what it is worth. I smoked for 50 years, the last 15-20 years 2 plus packs a day. I have tried quiting cigarettes many times. Sept 2 2007 was my last cigarette. I had been on Chantix a month as suggested but added the patch for 2 weeks before just using chantix. I should say I have been on a anti-depressent for several years. The bottom line. No tobacco product since sept. I found it much harder to quit tobacco than quiting alcohol and that was not fun ! I have just recently heard about these side effects. For me any potential side effects were worth it.

  49. SweetAtheist says:

    I started taking Chantix back in September of 07. My friend had the prescription, but didn’t want to use it so I took it home and did some research on-line and began the program. I was so determined to quit after smoking on and off for 25 years. I wasn’t a heavy smoker, but I was hooked. I followed the directions and before you know it you didn’t even want a cigarette. They didn’t taste good anymore and the urge was going, going, gone. Finally at the end of October I almost bought another pack of cigs, but thought to myself – no just stop. So it’s been 31/2 months now and I haven’t had a smoke one. I cannot believe the difference in so many aspects of my life. The money I save, the coughing stopped, the smell, oh I hated the smell, and the mess. I even bought a new car to get rid of the smokey smell. I have told so many of my ex-smoking buddies about Chantix and now about 3 or 4 women at work have started the program. When I see them around the building they always yell how long it’s been since they had a smoke. I know it’s not for everyone, but it was the right choice for me. My friend that gave me the Chantix in the first place has now stopped smoking herself. I believe you really want to quit in order to stop, so once you get to that point and willing to follow throught with it and stick to your guns you will succeed. The response from my two kids and my 82 year old mother when they found out I quit smoking was so worth it.

    Good luck smokers…

  50. savager says:

    i’ve been taking chantix for a week now.. I can say that it really kills your urge to smoke… almost probably 80% of it.. you still get a craving now and then but if you occupy yourself it’s not that bad at all.. i did catch myself beating my girlfriend,.. but hey.. i’m focused on quitting..

    just kidding…but yeah, i definitely get really angry out of the blue.. and I just realized I haven’t crapped in like 28 hours.. i think that’s it.. ohh and I fall asleep kind of out of the blue.. at like 11:30, and again at 4 and 6.. hhmmm. i think that’s it.. i’m trying to be as accurate as possible.. I don’t even know why I have the urge to smoke.. i’ve never smoked a cigarette.. but better safe than sorry.. i’ve always been curious about them..

    again.. just kidding.. i smoked a pack a day til last week.. it really is an amazing drug.. but unfortunately I do have most of those side effects.. i think i’m going to stop taking it in about a week.. and just do the luke warm turkey thing.. wish me luck.. don’t do drugs.. prescription drugs that is..

  51. mkerickson3 says:

    I think this article lacks serious scientific data to support its argument. I took Chantix before and successfully quit for more than 30 days. Of course, because of my stupidity, I went back to smoking and I am about to start another round of the drug. However, I think the majority of the people who committed suicide were probably suffering from other mental illness prior to beginning the regimen. Previously, I had no occurrences of vivid dreams or suicidal thoughts/behaviors. I don’t anticipate that I will have them again.

    Chantix had fewer side effects than the patch or gum did. The only thing I noticed was mild nausea if I didn’t eat when taking the drug.

  52. savager says:

    @mkerickson3: you sound like a pfizer employee

  53. Anonymous says:

    I did the chantix program and quit, using chantix, that is.
    Aside from the bad dreams, unreal “nightsweats”, constipation, abdominal cramping and the feeling that I was going to vomit throughout the day, the huge increase in feelings of depression really began to concern me. When my kidneys started hurting I knew enough was enough.
    I smoked again for about a month and then quit on my own terms. It can be done, probably the hardest thing I might ever do, but as the saying goes “mind over matter”.
    It will be three months in 2 days since I had a smoke…

  54. Just_tired says:

    I took Chantix just over a year ago, and stopped taking it because of the “unusual and vivid” dreams. Here it is one year later and I still don’t sleep well and still having those “unusual and vivid” dreams, I wake up every hour or two at the most from them, and it will be almost to the minute. I thought side effects mostly applyed to when you were taking the drug, but in my case that isn’t true. I was told of some side effects but didn’t plan on them for the rest of my life.