CHANTIX vs Vaping

[Eskie]

The only behavior you are likely to modify by taking Chantix for "other stuff" is that it may make you psychotically suicidal and/or homicidal, and the FDA may *enjoy* saying some of this is due to quitting. It's not. It also will not address "other stuff" it specifically targets nicotinic receptors in the brain, keeping them full and satiated, so that cravings are alleviated (supposedly) and if you smoke tobacco you *will not* feel anything, including satisfaction which does tend to be accurate for the most part.

It does work for some people, but I prefer not to be playing Russian Roulette with my harm reduction products, and it clearly does other stuff in the brain, as well, so IMO it's one of those "dirty drugs" where no one knows what the hell else it's doing (nor cares to investigate, since it's a smoker's "product.") I have literally no clue why it is still on the market and being prescribed, unless some doctors are sadistic in their feelings toward smokers. One of the nastiest drugs on the market, I'd rather swallow Haldol (the oldest typical antipsychotic on the market and it's AWFUL side-effect wise) than take Chantix. Seriously, for me it would be like playing Russian roulette with a FULLY LOADED gun. TY all the same, Big Pharma, but no thanks.

Anna

I was really trying to stay clear, but there is quite a collection of information that Chantix, while far from a perfect drug, is not associated with a higher risk of suicide than other NRT treatments. This includes a British study of 51,000 people who used Chantix compared to 100,000 people using regular NRT and found no difference in:

"there was no evidence of an increased risk of suicide or attempted suicide (odds ratio 1.67, 95% confidence interval 0.33 to 8.57), suicidal ideation (0.58, 0.28 to 1.20), depression (0.96, 0.75 to 1.22), irritability (0.98, 0.81 to 1.17), aggression (0.91, 0.52 to 1.59), or death (1.05, 0.47 to 2.38) in the varenicline users compared with placebo users."

However, these findings were not unexpected:

increased risk of sleep disorders (1.63, 1.29 to 2.07), insomnia (1.56, 1.36 to 1.78), abnormal dreams (2.38, 2.05 to 2.77), and fatigue (1.28, 1.06 to 1.55) but a reduced risk of anxiety (0.75, 0.61 to 0.93).

Risk of neuropsychiatric adverse events associated with varenicline: systematic review and meta-analysis | The BMJ

Meanwhile, in The Lancet (BTW, both of these journals are considered top tier and frequently used here to support vaping as safer than smoking, they found reduced risks for problems like stroke and heart failure in those who used Chantix compared to NRT (patch, gum stuff)

. Varenicline was associated with a significantly reduced risk of ischaemic heart disease (HR 0·80 [95%CI 0·72–0·87]), cerebral infarction (0·62 [0·52–0·73]), heart failure (0·61 [0·45–0·83]), arrhythmia (0·73 [0·60–0·88]), depression (0·66 [0·63–0·69]), and self-harm (0·56 [0·46–0·68]).

http://www.thelancet.com/journals/lanres/article/PIIS2213-2600(15)00320-3/abstract

Now those were observational and retrospective studies. Meanwhile, in a randomized, double blind study including placebo involving 8,000 people, they also split it roughly 4,000 folks with psychiatric problems and 4,000 without a psychiatric history, they found:

. In the non-psychiatric cohort, 13 (1·3%) of 990 participants reported moderate and severe neuropsychiatric adverse events in the varenicline group, 22 (2·2%) of 989 in the bupropion group, 25 (2·5%) of 1006 in the nicotine patch group, and 24 (2·4%) of 999 in the placebo group.

And:

. In the psychiatric cohort, moderate and severe neuropsychiatric adverse events were reported in 67 (6·5%) of 1026 participants in the varenicline group, 68 (6·7%) of 1017 in the bupropion group, 53 (5·2%) of 1016 in the nicotine patch group, and 50 (4·9%) of 1015 in the placebo group.

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30272-0/fulltext

That is not to say it is without side effects. Nothing, including vaping, is without side effects. But in fairness, while one's own reaction to a medication matters, it remains anecdotal. It is only when the data is collected and analyzed that correlations and conclusions can be reached.

Personal experience is meaningful but needs to be tempered by actual testing and observation. Otherwise, we sorta look like the folks around who say vaping is wore than smoking when the data is piling up to show the opposite.

tl;dr things may be more than just anecdotal "I read it here" sort of stuff we generally have negative reactions to.

 

[stols001]

Trying To Quit Smoking? Don’t Start With Chantix, Say Some Experts | TIME.com

Eskie, gotta say, though I should examine more recent research, a lot of the truly adverse side-effects don't get reported. They just do not. The black box warning is there, in case of lawsuit, and honestly, the last thing a doc who prescribed Chantix to a patient and they died or became very psychiatrically ill for a time, is to report it to the FDA. Family may not want that either. I think there is underreporting going on, where either the person is said to have had an "undiagnosed psychiatric condition" (not always correct), or they have severe and frightening side effects and stop the drug in time but no reporting happens.

That article above was from 2011! Many smokers I know are still being offered Chantix first, not Xyban. That is truly frightening and the article does point out overall quitting rates of 22% (after more than 3 months). That's crazy, I wouldn't risk suicide or homicide for a 22% chance of being smoke free for 3 months! Hell, being pregnant and nursing lasted longer quit-wise for me. I did once muse at my doc if I should have another kid to quit smoking, though.

He gave me a long stare and concluded with, "Anna, you could have twenty babies and then go back to smoking afterwards. You have to do it for yourself, so no I would not recommend that as a smoking cessation device."

I concluded his assessment was accurate.

I also conclude that Chantix may help 22% of the users who are trying it, maybe, because you know how it goes with statistics. I know a guy who took Chantix once, it worked great, several heart attacks later he is on it and still smoking and looking kind of wonky to me (he's not a close friend, he says he has people monitoring him, so I can't do much other than be generally concerned).

There may be a place for Chantix in the harm reduction stable, but it's in the last stall, and more care should be exercised than is being exercised. Routine monitoring and f/u by doctors, for example. You don't just hand someone a 12 week supply and say, "See you later." You don't expect most patients to read their literature about what to do if they start feeling weird, you go over that information. Etc. A lot of the time that doesn't happen, from what I've seen.


Anna

 

[zoiDman]

...

That is not to say it is without side effects. Nothing, including vaping, is without side effects. ...

True.

But when 2 possible Side Effects are compared, Vaping - Dry Mouth vs. Chantix - Jumping Out of a Window, are we really talking about Similar Levels of Effect?

 

[Eskie]

Anna, I agree no one should ever be handed a supply of medication and sent out the door without instructions for use and side effects to be aware of. I tried Chantix as well to stop smoking, and all it did was make me lose any desire for coffee, which was pretty bizarre and for me unacceptable.

The Time article is from 2011, and the studies I linked to are from 2015 and 2016, which is a bit more up to date than that story. They also satisfy what we would love to see for vaping, not just a retrospective "what happens to a bunch of vapers over several years" but a completed true double blind, randomized trial, which is about the best you're going to get in medical research. That's the gold standard. And that's why the black box was removed in 2016.

My issue is that everyone needs to decide their comfort level for themselves what they do and do not decide to put in their own bodies. That decision should be made with all the information available, along with clear instructions on what to expect and what to watch out for. But it's tough to deny a study of 8,000 people that found no difference and there's no issue of how many episodes or side effects were gathered by self reporting only. I also agree that self reporting is not a great way to track anything as you don't know what you might miss. But that wasn't what was relied upon in those studies

 

[stols001]

Well, Eskie, that's fair enough. When I have time I'll take a look at those studies. I do agree that anyone has the right to try whatever they are willing to try in order to quit, and I do agree that patients should be well informed as to what they are getting into. I really haven't thought about Chantix in a long time, but quit lines trying to push it on a diagnosed psychiatric patient isn't a good idea either, and it did happen to me, which I found pretty unacceptable and I do think that there are other harm reduction options out there that are safer and have a higher quit rate (vaping being one of them, snus another, for example). Though, I suppose that if you are going to ask a doctor for medical advice to quit smoking, it's in their wheelhouse to offer a pill or other "medical" product. I do think that's a shame and I do hope that going forward, Chantix is the last option to try.

I got vivid dreams on the patch and I kind of enjoyed it because I didn't dream much. It did feel odd, however. There are risks/repurcussions with any harm reduction product I guess, hence the name "harm reduction."

I haven't met too many long-term ex-smokers who did it with Chantix though I have met a few. I'll take a look at your studies, however, and I am more interested in what docs are prescribing first and hoping to find some comparative info on Xyban prescriptions vs Chantix prescriptions.

Gotta go eclipse!

Anna

 

[Bad Ninja]

Xyban made my thoughts slower and dulled my reaction time.

While it didnt make me suicidal or anything like that, working in a machine shop with a foggy head and slow reaction time is a great way to lose an appendage, or your life.

 

[Eskie]

I got vivid dreams on the patch and I kind of enjoyed it because I didn't dream much. It did feel odd, however. There are risks/repurcussions with any harm reduction product I guess, hence the name "harm reduction."

Oh, I had the same issue with the patch, but hated the dream stuff. I had to take it off an hour before bedtime.

 

[zoiDman]

What's that Old Say'n.... "A Study is Only as Good as the Data Collected"

"...

In the FDA staff report, the agency offered an unusually pointed assessment of the payments and their relationship to doctors’ findings in the study. At two sites, the agency reported that doctors got “as many as 60 separate honoraria for speaking engagements and consulting fees.”

In sites where doctors received $25,000 or more from Pfizer, according to the FDA, only 1.8 percent of patients who had already been diagnosed with a psychiatric disorder were reported to have side effects, such as anxiety, agitation, hostility or suicidal thoughts, during the study. At locations where physicians received less money or none at all, 6.4 percent of patients reported such problems.

..."

Doctors Downplaying Drug’s Suicide Risks Attract FDA’s Scrutiny

Man! By the time the FDA thinks something might be wrong, things are Probably Pretty Bad.

 

[stols001]

I read the above link, ^^^^ interesting find.

I sometimes think people put too much stock in double blinded studies if doctors are being paid, not necessarily to under-report on purpose, but more because docs who are receiving payments and possible future opportunities to present and publish on the drug will have their own type of "placebo" effect. They want the drug to work, and they also want their findings (even subconsciously) to be positive. They may think they are operating independently and without bias, that bias will be present regardless.

I genuinely believe with most docs, that isn't on purpose, or deliberate, or anything of the sort. However, I'd say most researchers want to be successful in their research, and to have it go somewhere positive. If a researcher is being funded financially, that's even more problematic to remove bias. Patients pick up on these matters, regardless of what "words" or "questions" are being asked, and patients want to have a good outcome, also. Since Placebo IS a very powerful effect, either docs are under-reporting or patients are minimizing sx to "please" the researchers or to hope to have a good outcome also. (IMHO).

Bias is extraordinarily hard to remove, even with the best intentions possible. That's true for all people, including doctors. It's fair to say that I have a bias that Chantix is more harmful than what is being reported and here it is being said again in 2016, BY the FDA, one of the most bias groups I know of as far as being pro-medication (though to be fair, they do remove drugs from the market and they are concerned about removal of the black box label).

I am concerned about that as well, especially as people in clinical trials are going to have far more interaction with their medical professional than they likely will in the real world.

With that being said, I don't want to fight against Chantix necessarily for all patients, but I would like to see it used as a last resort, with some pretty stringent screening, and medical follow up as needed. Just like vaping, anyone engaging in "harm reduction" is changing some pretty significant habits. Being told by a doctor that one is doing well or even going in for a visit IS a form of support, and clinical studies do that rather well. Support is necessary for changing habits however it is done, is kinda my thing....

Either way, I can see a place for Chantix for those who wish to try it, but I do think there should be safety and follow up plans in place, and I really think it is in the darkest corner of the stable where cobwebs sit and spiders lurk.

One of my best friends back East had lung cancer and a lung removed. She was put on Chantix, kept smoking, relapsed on other substances and I have no clue what ended up happening to her. I think she might have been on Xyban *at the same time*. I get that her docs were doing EVERYTHING they could think of to get her to quit smoking, she started at some ungodly age, but doing EVERYTHING may have actually shortened her life, not extended it. I wish vaping had been around then. Knowing her personality, she may have enjoyed it.

Anna

 

[zoiDman]

I read the above link, ^^^^ interesting find.

...

I think what Many Found to be Bewildering is when they saw this...

"Funding
Pfizer and GlaxoSmithKline."

... when they looked at this "Study".

http://thelancet.com/journals/lancet/article/PIIS0140-6736(16)30272-0/fulltext

To put it in Simple Terms. Isn't that like the Maker of RTA doing there own Review and then telling people how Great it Is?

And as if that Isn't Bad Enough, or a CLEAR Conflict of Interest, it is latter found that Independent Reviewers of the RTA were Far Less Likely to Report Problems when they had received Halliburton's full of Money from the RTA's maker than those who Didn't.

 

[zoiDman]

I read the above link, ^^^^ interesting find.

...

BTW - All this was Kicked around in this Thread from Dec. 2016 ...


Who said the FDA is a Tool of BP?

 

[Canadian_Vaper]

I tried chantix, it helped me quit smoking but made me very aggressive, my wife asked me to stop using it so I did and went on to continue smoking.

 

[bobwho77]

I had bad reactions to Prozac, when I was prescribed for depression back in the mid 90s. (Shaking, violent mood swings, nightmares...)
Coming off of it was an extended ride on the roller coaster from hell.
When the doctor I was going to suggested Chantix to stop smoking, I changed doctors.

 

[zoiDman]

...
When the doctor I was going to suggested Chantix to stop smoking, I changed doctors.

I feel Very Fortunate in those regards. Because when Chantix first hit the Streets, I called and asked my Doctor about getting a prescription for it.

She Told No How - No Way would She write a prescription for Me or any of Her other patients.

This had a Profound Effect on me because She had dogged me for Years to try anything to Quit Smoking.

 

[ScandaLeX]

Hopefully her friends and family are doing something about that, as this may progress to something awful really fast, especially if she doesn't have insight. She needs to be taken back to her provider and have whoever takes her come with to describe her symptoms, ASAP. She may also need a psychiatrist's help to get things straightened out in her brain, depending on how bad it has gotten. NO INSIGHT is not a good symptom to have, generally, but with Chantix in particular. This is AN EMERGENCY in case I am not making myself clear. People die or kill on Chantix more frequently than is ever reported.

PLEASE work with someone close to your friend to get her help. You may lose her friendship over it, (possibly... possibly not when her insight returns) but she won't lose her life. It's incredibly awful when these situations happen, but if she is completely oblivious to what's going on, she needs to be strong armed, (IMO) due to how swiftly this drug can turn on a person. I hardly EVER recommend that, I'm not a huge fan of forced intervention but there are times it is necessary.

Back when I was unstable, I was never upset with my family for forcing a psych visit on me, or my doc indicating I needed a hospitalization even, I want to a) live b) not destroy my family and friends with bad decision making. I'm thrilled to be stable now, but I remember the bad times during my first 8 years or so of treatment. I don't begrudge my family taking actions, though not every person feels the same way.

I will be praying for your friend and that she gets the help she needs, pronto.

Anna

I'm not doing all that. Some people you can't tell what to do or even advise them....she's one of them. I've learned for people like that, I serve myself well by not making their issues my problem.

 

[HauntedMyst]

If they want to make an effective pill for stopping smoking, they need to do something like Alli for weight loss. When you take Alli for weight loss, if you overeat, you get ........ and crap your pants. Make a pill that makes you crap your pants when you smoke and people would be quitting in waves. Giant, stinky brown waves.

 

[stols001]

It's the Year of the Depends Adult Undergarment!

I will smile at anyone who gets the reference....

Anna

 

[Eskie]

If they want to make an effective pill for stopping smoking, they need to do something like Alli for weight loss. When you take Alli for weight loss, if you overeat, you get ........ and crap your pants. Make a pill that makes you crap your pants when you smoke and people would be quitting in waves. Giant, stinky brown waves.

Like that really would have stopped me from smoking.