Chantix: One Woman's Story

Cincinnati, OHChantix looked like a sure winner going in, Lucy writes on her blog. But it sure exposed its dark side on the way out. Lucy, a resident of Ohio and a former smoker, had tried quitting a few times over the years, without success. Then Pfizer came along with its so-called wonder drug Chantix, designed to help smokers quit the dreaded tobacco in a boffo new way.

Everybody was upbeat. Lucy's doctor was eager to write a prescription, and even the nurses in the office were commenting about this 'wonderful new drug,' Lucy writes.
Early in 2007 and with her New Years resolution still fresh, Lucy smoked her last cigarette, and then it was off to the drug store for Chantix.

If first impressions are everything, Chantix delivered. Together with a friend, who had started Chantix a week before, the two women marveled at how the drug made smoking completely unpleasureable. "But at the same time, we knew that it must be a pretty strong drug to affect our brains that way."

Chantix targets receptors in the brain that respond to nicotine. When a person inhales, nicotine is absorbed into the blood and travels to the brain, reaching certain receptors that respond to nicotine. That response is the release of dopamine, which results in a feeling of pleasure. However, as most smokers will tell you, it doesn't last long, leaving the smoker to reach for the lighter yet again.

Most smoking cessation therapies are based on the theory that a gradual reduction of nicotine over time will reduce the dependency. However with Chantix, Pfizer went right to the source. Targeting, as it does those specific brain receptors that respond to nicotine and release dopamine, Chantix prevents nicotine from reaching those receptors. As a result, release of dopamine is radically reduced, or eliminated altogether.

Eliminate the dopamine, and you take away the pleasure from smoking - or at least, that's how it appeared to the Ohio blogger when she was on Chantix in the beginning.
First impressions were great. However, the bloom was soon off the rose.

The two Chantix friends were now starting to have vivid dreams. They would get irritable if they forgot to take their pills. Lucy began to suffer from dizziness, to the point of nearly fainting dead away several times a day.

She decided then and there, that she wanted off Chantix. But she knew quitting cold turkey would be a mistake, so she endeavored to wean herself off the drug slowly, decreasing her dose.

That's when Chantix turned ugly for Lucy. By day four without the drug, her hands wouldn't stop shaking. Nor could she stop crying. While she didn't suffer from suicidal thoughts, she could no longer find a reason to get up in the morning, to bathe, to get off the couch. Meditation and yoga didn't help. Vitamins and B Complex didn't help.

Finally, when she was set to open a bottle of wine to take the edge off at 8am, she knew she had to go back to her doctor.

In his opinion, Lucy's symptoms were from nicotine withdrawal, but Lucy disagrees. She describes having quit smoking during two pregnancies, and both times she had never experienced the kind of symptoms she had been suffering from Chantix. And her friend, who went the full three months with Chantix, described similar symptoms.

Chantix recently updated the safety information on its web site, in response to increasing reports of suicidal thoughts, together with a myriad of other complaints that have surfaced in recent weeks. The manufacturer stresses the importance of remaining in concert with your doctor, and that any Chantix smoking cessation therapy should be closely monitored.

An interesting sidelight is that while Chantix, and its supporters know what it is designed to do, they can't really say how it works, or why.

"Based on research, it is believed that CHANTIX helps keep nicotine from reaching key receptors in the brain. It's the only prescription treatment of its kind."

Pfizer uses the word 'believe' on two other occasions on its web site, in a small, illustrated tutorial describing the relationship Chantix has with the brain.

"Based on research, it is believed that CHANTIX works by blocking nicotine from attaching to the receptors."

And in the next panel,

"It is believed that CHANTIX activates these receptors causing a reduced release of dopamine compared to nicotine."

In other words, Pfizer thinks it knows how it works, but they're not sure. Or at the very least, they're not prepared to say.

In the end, bunnies and turtles are playful metaphors for the difficulty, and the triumph of quitting. But anyone playing with your brain, had better know what they're doing...