Chantix: One Man's Compelling Story

New York, NYOne has only to read the revealing essay by writer Derek De Koff in New York Magazine, to get a true appreciation for the risks, and the reality of Chantix—a smoking cessation medication that has resulted in thousands of adverse affect reports to the US Food and Drug Administration (FDA), and several actual suicides.

Two deaths in particular have caught the world's attention. One was Carter Albrecht, a musician and one-time member of the band Edie Brickell and the New Bohemians (Brickell is married to musician Paul Simon). On Chantix for barely a few weeks, Albrecht turned on his girlfriend before attempting to break into a neighbor's home. The startled homeowner fired a bullet through the door, killing the musician on September 3rd, 2007.

However, it was the tragic death of Omer Jama, a 39-year-old video editor from England that really focused the world's attention to the darker side of Chantix, which is marketed as Champix in the UK. Jama had been eager to kick his smoking habit, and had heard about the 'revolutionary' Champix. "He was so excited about giving up smoking," said his brother Ali, 41, "like a kid waiting for Christmas."

Jama was prescribed Champix by his physician. Jama's family and friends indicated that he had no history of depression or mental illness, and just days before his death had booked a holiday to Cuba, about which he was looking so forward.

It was not long before he was found dead in his Manchester flat, both wrists slit. Omer's brother Ali immediately thought of the pills, according to a report in the The Sun. A friend had started on Champix and suffered violent mood swings. "But Omer wasn't worried about taking them himself because he had no history of moodiness.

"It was totally out of character for him to do something like this."

American writer De Koff's experience with Chantix in New York is equally revealing, according to his sprawling essay that delves into the approval process of Chantix. Specifically 3,659 individuals were carefully selected for the pre-market trial. Those with any history of depression, panic disorder, heart disease, alcohol or drug abuse, diabetes, or people with kidney or liver issues were excluded from the testing. A spokesperson from Pfizer told De Koff that the Chantix manufacturer had to isolate the different variables that could affect the outcome, in order to satisfy FDA criteria. A spokesperson with the FDA confirmed that it is indeed not unusual to exclude participants with major psychological or medical illness from certain clinical trials.

However, given the expected and realized widespread appeal of Chantix and Champix, medication that would be presumably used by people with the very conditions Pfizer excluded from the trial, the results of the clinical trial clearing Chantix/Champix for market could hardly be seen as a true representation.

Sure enough, some Chantix users with a history of psychiatric difficulty, had difficulty with Chantix. However, so too did people who had no prior emotional axes to grind.

Writer De Koff was one of them. Almost immediately after starting on the Chantix program, he reports having extremely vivid, and sometimes disturbing dreams that over time began to take on epic proportions. De Koff also notes that sleep while on Chantix took on an unusual quality...that he wasn't really sleeping at all, but was resting while being constantly 'on guard' for something. He alludes to an assumption that his R.E.M. sleep patterns were dramatically affected during this time.

While admitting that smoking cigarettes had become "an exercise in futility" as there was no pleasure to be found, his dreams and everything else happening during his waking hours were becoming a concern.

"One afternoon, I was typing away at advertising copy, and as I did so, I began to wonder how I had succeeded in fooling myself that my life had any sort of value at all," De Koff writes. "Writing? Sure, it was what I'd wanted to do since I was six—but at the end of the day, who cared? Maybe I should just go downstairs and leap in front of a tour bus. Or launch my head through the computer screen. All this seemed logical, but also weirdly funny, even at the time: I could see how crazy these impulses were, I could recognize them as suicidal clichés. But I couldn't make them go away."

An acquaintance on Chantix told him that it was getting easier by the day and the nausea, which De Koff experienced the first day on Chantix, had stopped. But another Chantix user told him that the medication worked, but left him feeling temporarily 'lobotomized.'

Elizabeth, a 48-year-old musician, told De Koff, "Chantix made me desperately suicidal, just crazy. I joked to my friends that Chantix was the ultimate quit-smoking drug, because when you kill yourself, there's no chance of relapse."

Chantix works by blocking the pathway taken by nicotine to reach those receptors in the brain that release dopamine, the chemical responsible for pleasurable feeling. That's where the hit of pleasure after taking a puff comes from. In theory, if you take away the pleasure, kicking the smoking habit will become easier—especially if you lose your resolve and light up, only to find that smoking does nothing for you. That long-loved feeling of pleasure from smoking is no longer there.

Pfizer has said that not ALL dopamine is shut off, but just enough to take away the pleasure derived from smoking.

Meanwhile, De Koff was becoming uncharacteristically reclusive, and began to wonder 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."

In the end, after more bouts with disturbing and uncharacteristic behavior, De Koff ditched Chantix and went onto the nicotine patch. He chronicled his story in a compelling essay entitled, 'This is My Brain on Chantix,' published in New York Magazine February 10th, 2008.

Pfizer reported Chantix sales at $280 million for the fourth quarter of 2007, up from $68 million a year earlier. The FDA has cited 34 actual suicides, and 420 instances of suicidal behavior in the U.S.

Lawyers expect to be busy.