Chantix should be a last resort

A new study suggests that Chantix should be a last resort tool for smoking cessation:

The psychiatric side effects of a popular quit-smoking drug make it too dangerous to use as a first attempt to kick the habit, according to a new study. The authors suggest the drug should eventually be taken off the market altogether.

The new study on the safety of varenicline (Chantix), appearing in the journal PLoS One, found that when compared with other smoking-cessation treatments, including nicotine replacement and the antidepressant bupropion (Zyban), varenicline was associated with significantly more cases of suicide, self-injury and depression. Varenicline was linked to 90% of 3,249 reported cases of self-harm or depression in people using quit-smoking drugs between 1998 and 2010, the study found, compared with 3% for nicotine replacement and 7% for bupropion.

…Dr. Curt Furberg, professor of health sciences at Wake Forest Baptist Medical Center and an author of the latest study, notes that his analysis found that varenicline resulted in many more cases of mental disturbances than bupropion. Given its safety profile, he argues that varenicline should be used only as a last resort for smokers who have tried other methods — including behavior modification, nicotine replacement and bupropion — and still can’t quit.

The Veterans Affairs Administration already uses varenicline by these guidelines, and Furberg approves of the policy. “They got it right,” he says. “They have restricted use of Chantix to a last-resort drug. They say when you try to get people to quit, and if you need a drug, start off with nicotine replacement and then Zyban. If they don’t work, then use Chantix. But if you do, you need to monitor mental status to see if people are suicidal in any way.”

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