[NPInfo] Chantix and Psych effects

[Dena]

I had a PTSD patient who really wanted Chantix as nothing else had worked in
the past for smoking cessation. As he was already on Wellbutrin (which
wasn't helping the smoking cessation at all) and other psych meds for his
PTSD, I contacted his psych who told me that no patient with a psych history
or problems with sleep should be RX'd Chantix. Glad I learned that lesson
before my patient went beserk!! I have only ordered it for 2 patients-- one
who successfully quit smoking on it (but has since died of unrelated
problems-- or at least I hope it was unrelated!!) and one who lives out of
state. Guess I need to call the latter to check up on him although his 12
weeks of treatment should be finished by now. Luckily, the VA has a big
smoking cessation program and all I have to do is place a consult and the
anti-smoking people take care of the rest-- counseling AND ordering the
meds.
Dena Galler

-----Original Message-----
From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf
Of Christine Smith
Sent: Saturday, November 24, 2007 3:56 PM
To: acc-circle at listserve.com; 'NP Info'
Subject: [NPInfo] Chantix and Psych effects

This is a bit alarming to me. I typically try to avoid new drugs on the
market for at least one year or longer, but Chantix had such benefits and
good resuits that I broke one of my own rules.  I rx'd Chantix to a
friend/hospital employee last May who has very controlled Bi-Polar disease.
In July, he was went beserk in a department store, stole some items with his
young daughter present, went into a manic state to the point of
hospitalization after three days in jail. His psych thought his usual meds
were failing him and did a wash-out and then restarted his meds with some
changes. He is doing well now - back to his normal state and back at work.
However, he is in the midst of paying some fines and court fights over
custody of his daughter (which was fine before the event). He does not even
recall the event in the store - only remembers vaguely being in jail and
then in the hospital. He was on Seroquel, Effexor and Lithium both before
and now. I had consulted with his psych about using Chantix before and it
was agreed that it would be good as patient was really trying to make some
positive changes in his life.

 

I also rx'd Chantix to another patient - no diagnosed Psych hx in July. In
September she went into a deep depression after her daughter went to
college. I thought it was a bit of empty nest syndrome - sort of extreme -
but did not think it was the Chantix. She is now on a bit of Celexa and
doing ok but no longer on the Chantix.

 

Christine Smith, NP

Antioch, CA

 

 

 

 

 

Please Note! The FDA sent this alert to " Healthcare Professionals". How
about asking them to continue this verbiage as a means of support for NP's
and PA's.

Bob


	

FDA informed healthcare professionals of reports of suicidal thoughts and
aggressive and erratic behavior in patient who have taken Chantix, a smoking
cessation product. There are also reports of patients experiencing
drowsiness that affected their ability to drive or operate machinery. FDA is
currently reviewing these cases, along with other recent reports. A
preliminary assessment reveals that many of the cases reflect new-onset of
depressed mood, suicidal ideation, and changes in emotion and behavior
within days to weeks of initiating Chantix treatment. The role of Chantix in
these cases is not clear because smoking cessation, with or without
treatment, is associated with nicotine withdrawal symptoms and has also been
associated with the exacerbation of underlying psychiatric illness. However,
not all patients described in the cases had preexisting psychiatric illness
and not all had discontinued smoking. 

Healthcare professionals should monitor patients taking Chantix for behavior
and mood changes. Patients taking this product should report behavior or
mood changes to their doctor and use caution when driving or operating
machinery until they know how quitting smoking with Chantix may affect them.


Read the complete 2007 MedWatch safety summary including a link to the FDA
Early Communication Sheet about an Ongoing Safety Review regarding this
issue at: http://www.fda.gov/medwatch/safety/2007/safety07.htm#Chantix. 


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