Will Chantix Give You Thoughts of Killing Yourself?

Are you worried that Chantix would make you suicidal? Is the idea of Chantix giving you thoughts of killing yourself keep you up at night? This is the single most important question a person needs to know before taking Chantix (varenicline).

Let me answer the question in two parts:

1) Firstly for most people the answer will be NO. Chantix will NOT make you suicidal. As a matter of fact for most people Chantix will not be a problem at all.

2) My observed rate of success with Chantix is about 80%. This means that 8 out of 10 people who try Chantix will have no problem at all with the drug. For the majority of people it is matter of just taking the medicine and “puff” like magic the desire to smoke evaporates. If anything Chantix makes quitting way too easy. And as a result some people who successfully stopped smoking for months come back to smoking because they feel they can quit again at anytime with the pill.

2) Now for the 20% of the Chantix users who will experience side effect. For those 2 out of 10  you will discontinue the drug’s use. But hopefully this minority of people will not give up their hope of being smoke free and will simply elect another method to quit.

Some in this minority WILL have suicidal thoughts no questions about that. But here is the problem with saying that Chantix caused the suicidal thinking. 

There are a number of people who smoke who have a un-diagnosed condition that causes them to become addicted to nicotine. For example, it is well know the percentage of smokers in the general U.S. population is about 25 to 30 percent, but the prevalence among people with schizophrenia is approximately 80-90%.  So these schizophrenics are unknowingly self-medicating with nicotine and keeping their disease in check.

So what is my point? Some of these (undiagnosed) schizophrenics will take Chantix to quit smoking but soon after will start exhibiting the symptoms of schizophrenia. And what are the symptoms of schizophrenia? The include the following symptoms: (This list is not exhaustive).

1. Delusions.
2. Thought disorder.
3. Disorganized behavior.
4. Loss of interest in everyday activities.
5. Appearing to lack emotion.
6. Reduced ability to plan or carry out activities.
7. Neglect of personal hygiene.
8. Social withdrawal.
9. Loss of motivation.
10. Problems with making sense of information.
11. Difficulty paying attention.
12. Memory problems.
13. Withdrawal from friends and family.
14. Decreased performance at school, or/and at work.
15. Trouble sleeping.
16. Irritability.
17. Etc, etc, etc…
    

So consequently these individuals will appear to be exhibiting symptoms as a result of Chantix use. But in really it is just the unmasking of a preexisting underlying condition and it is NOT Chantix that should carry the blame. Oh and I almost forgot … people with schizophrenia can become depressed and depressed people often think about committing suicide.

Because of these CONFOUNDING variables the question of whether the suicidal thoughts came from using the or not or not is impossible to answer. Because these individuals are usually depressed and depressed people often think of killing themselves without prompting from any drug.

(In statistics a confounding variable is a hidden variable, a lurking variable,  that muddles the water and erroneously causes incorrect conclusions to be reached.)

photo credit: edalisse

Comparison of Chantix and Emergency Surgery.

In 1981 U.S. President Ronald Reagan was shot in the chest. He suffered a punctured lung and was bleeding internally into his chest. This is called a hemothorax. A patient with an undiagnosed hemothorax can bleed into their chest and die in minutes. Had the president not had surgery to repair the damage he most likely would have died.

Like president Reagan many people have emergency surgery to attempt to save their lives. So people live and some people still die in spite of the heroic measures to save their lives. As a matter of fact trauma patients who need emergency surgery have a significantly higher mortality rate than the population of individuals who have elective surgery. If someone who is shot and bleeding gets rushed to the ER and the doctors operate to try to save this persons’ life.  The ER patients risk of dying is many times higher than the person who schedules a surgery with their doctor to do a simple procedure (hernia surgery for example).

Here is another example of confounding. The unfortunate ER patients who die after attempts of life-saving surgery, do so because they had surgery? or were they going to die anyway?

Some would argue incorrectly that we should never try life-saving-emergency-surgery (because of the increase mortality and morbidity associated with life-saving emergency surgery) but what about the one person who lives as a result of the surgery. Is it not worth trying to save one life?

Chantix helps 80% of the people who take it. These people who couldn’t stop themselves from smoking have now stopped and are consequently healthier. Should we stop prescribing Chantix because one person who may or may not eventually think about killing themselves? And most of the time they do not and Chantix is stopped?

My personal opinion is that Chantix does not cause people to think about suicide. But suicide does occur in people who take Chantix because they have some underlying condition like depression and not because they take the drug. But even in those with mental condition can be helped with Chantix with close medical supervision of an experienced physician.

I hope this makes sense.