[NPInfo] Chantix and Psych effects

[Margaret A. Fitzgerald, DNP, NP-C, APRN, BC, FAANP, CSP]

I had a family member who is on an SSRI and Ritalin have what looked like a catatonic, non responsive episode that lasted about 15 mins while on Chantix. He was also still smoking. Really terrifying, resulted in a complete neuro WU that was neg, stopped the Chantix, did kind of the same med washout as Christine describes while his treatment regimen was reorganized. 
 
I have had some great successes with the drug, however. Dr. Margaret A. Fitzgerald, DNP, APRN, BC, NP-C, FAANP, CSP  President, Fitzgerald Health Education Associates, Inc.  85 Flagship Drive  North Andover, MA 01845-6154  978.794.8366  FNP, Adjunct Faculty, Family Practice Residency  Greater Lawrence (MA) Family Health Center, Inc.  FHEA website www.fhea.com  FHEA on line store www.fhea.biz 



> From: chrisbsmith at mindspring.com> To: acc-circle at listserve.com; npinfo at nurse.net> Date: Sat, 24 Nov 2007 15:56:23 -0800> 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. > > > _____ > > > _______________________________________________> NPInfo mailing list> NPInfo at nurse.net> http://lists.nurse.net/mailman/listinfo/npinfo> *****************************> >