Quit-Smoking Drugs and Nicotine Patches and Gums
What can help you quit smoking?
Varenicline, the latest antismoking drug to win FDA approval, works by blocking nicotine receptors in the brain. It is sold under the trade name Chantix in the U.S. and Champix in other parts of the world. Chantix is usually prescribed for a 12-week period, with the option of another 12-week maintenance course. About 33% of smokers who use the drug successfully quit.
Is it right for you? Chantix is effective in lessening nicotine cravings and has helped many smokers successfully quit. Unlike Zyban, it should not be used in combination with nicotine replacement therapies (unless under a doctor’s supervision.) Chantix was approved in 2006. Side effects include nausea, vomiting,abnormal dreams, constipation, and flatulence. In 2009, the FDA required Chantix to have a boxed warning about serious neuropsychiatric events, including depression, suicidal thoughts, suicidal behavior, agitation, and hostility. Also, those who take Chantix may be at higher risk for heart attacks and strokes compared to those who don’t take the drug, the FDA says. Some serious side effect symptoms may be related to nicotine withdrawal.
Expert advice: “If you and your doctor decide to try Chantix, it’s important to monitor your moods and alert your doctor immediately if you notice any change,” says Steven Schroeder, MD, director of the Smoking Cessation Leadership Center at the University of California, San Francisco. Some of the less serious but still unpleasant side effects of the drug, such as nausea, often go away over time.
Zyban (Bupropion SR)
Approved in 1997, Zyban acts on chemicals in the brain to ease nicotine withdrawal symptoms, making it easier for smokers to resist the craving to light up. The pills are usually taken twice a day for a period of seven to 12 weeks. Some ex-smokers may need to remain on Zyban for longer periods. About 24% of smokers who use Zyban successfully quit.
Is it right for you? Zyban is especially helpful for people with intense nicotine withdrawal symptoms. It can be used alone or in combination with nicotine replacement therapies such as patches or gum. The FDA has required Zyban to have a boxed warning for serious neuropsychiatric events, including depression, suicidal thoughts, suicidal behavior, agitation, and hostility. Some serious side effect symptoms may be related to nicotine withdrawal. The drug is not recommended for people with seizure disorders, bulimia, anorexia, or patients who are abruptly stopping use of alcohol or sedatives, or are using a monoamine oxidase (MAO) inhibitor. The most common side effects are dry mouth and insomnia.
Expert advice: Zyban should be started a week or two before your quit date to tame nicotine withdrawal symptoms. Like all drugs, it should be taken as recommended. Contact a health care provider right away if agitation, hostility, depressed mood, suicidal thoughts/behavior, or other changes in thinking or behavior develop.