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Anti-smoking drug tied to serious mental illness
[April 18, 2008]

Anti-smoking drug tied to serious mental illness


(Milwaukee Journal Sentinel, The (KRT) Via Thomson Dialog NewsEdge) Apr. 18--PUBLIC INVESTIGATOR: TAKING TIPS, CHASING LEADS, SOLVING PROBLEMS

Melinda and Kenny Peterson wanted to kick their two-pack-a-day smoking habit.

In early January, the Green Bay couple started taking three-month prescriptions of Chantix, a new anti-smoking pill. About six weeks later, they weren't smoking at all.

But what the Petersons didn't know was that as they were weaning themselves off cigarettes, the U.S. Food and Drug Administration issued an alert: Some patients taking the powerful drug had experienced serious neuropsychiatric symptoms. And Pfizer, the maker of Chantix, had recently added a warning about these symptoms in a more prominent position in the drug's information packet, at the FDA's urging.

The alert was issued in early February. But the Petersons didn't know about it until the end of March, when a friend who was a pharmacist filled them in.

By then, it was too late. About a week earlier, Kenny Peterson had spiraled into a deep depression. He told his wife he wanted to kill himself. His family checked him into a hospital psychiatric ward four days before Easter.


Chantix's safety is now under fire, as similar stories of patients with suicidal thoughts, depression and aggressive behavior surface. The FDA received reports of 37 suicides and 491 cases in which people had suicidal thoughts. The FDA also said it "appears increasingly likely that there is an association between Chantix and serious neuropsychiatric symptoms." About 5 million people use the drug.

"I think the jury is still out on what's going on here," said Carlyle Chan, a professor in the psychiatric department at the Medical College of Wisconsin. "Be aware that there are some concerns about (Chantix). It needs to be watched closely."

A Pfizer spokeswoman said the company was rolling out Chantix globally but halted advertising the drug to consumers in February. The FDA approved the drug in May 2006.

The company maintained that the serious neuropsychiatric symptoms are rare, but physicians and patients should be on the lookout for them. Pfizer said a causal relationship between the drug and these symptoms has not been determined.

"The real problem out there right now is smoking," Senior Vice President and Chief Medical Officer Joe Feczko said at a health investor conference in March.

Chantix can help shrink the global population of 1.3 billion smokers, he said, thus addressing health problems such as cancer and cardiovascular disease. In 2007, Chantix brought in $883 million in revenue.

Chantix, known generically as varenicline, works by blocking nicotine receptors in the brain. When people smoke, nicotine attaches to receptors and the brain releases the chemical dopamine, which gives pleasure. Chantix activates the receptors and blocks nicotine from attaching to them.

The drug now includes a mention of possible serious neuropsychiatric symptoms in a warning section of the printed information that accompanies each prescription and is folded inside the packaging. Previously, the information was in a less prominent place in a section of the drug's literature in which "adverse events" were reported. But there is no requirement to put the warning on the actual package because the FDA hasn't mandated it.

None of this is comforting to Melinda Peterson, who believes that Chantix cost her family too much.

In the psychiatric ward, Kenny Peterson was diagnosed with bipolar disorder. He's out of the hospital now but can't work, and his doctors said they wouldn't know when he would be able to work.

"He is completely mentally ill right now," Melinda Peterson said. "My belief is that the drug caused him to go into a manic episode. He has paranoia. He has delusions."

Chan said it was unclear whether Chantix actually caused depression and suicidal thoughts or whether Chantix exacerbated the symptoms of people who already have some sort of depressive behavior.

The FDA reported that it has seen both types of situations -- some in which patients had no history of depression, and cases in which depression previously was an issue.

What's the problem?

A reader said he counted more than 100 burned-out lights along 794 in Cudahy, St. Francis and Milwaukee. A light pole north of Oklahoma Ave. has also been down for more than one year.

Is it fixed?

The Wisconsin Department of Transportation knows about the knocked-down light pole. The repair needed to wait until the ground was soft, and it is to be completed this spring. As for the lights, the department said it was aware of the burned-out lamps along the freeway. Some are to be repaired this spring, but budget cuts in 2006 and 2007 have created a backlog of darkened street lamps.

To see more of the Milwaukee Journal Sentinel, or to subscribe to the newspaper, go to http://www.jsonline.com.

Copyright (c) 2008, Milwaukee Journal Sentinel
Distributed by McClatchy-Tribune Information Services.
For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.

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