Stop-smoking medication varenicline (Chantix)

Cigarette smokers who want to quit have several medications to choose from to help in their effort to stop smoking. Chantix works by blocking the effect that nicotine has on the brain. Chantix may make it easier to stop smoking.

Nicotine replacement products, including the patch, gum and lozenges, and the antidepressant bupropion (Zyban), can help you stop smoking, in part, by continuing to release low levels of dopamine in your brain. In this way, these stop-smoking medications decrease your craving for nicotine and reduce the signs and symptoms of withdrawal.

Chantix works in this way, too. Chantix stimulates the release of low levels of dopamine in your brain to help reduce the signs and symptoms of withdrawal. In addition, Chantix blocks nicotine receptors in your brain. So if you lapse and have a cigarette, your cigarette doesn’t stimulate your brain’s receptors the way it did in the past. Cigarettes become much less pleasurable, and your desire to return to regular smoking again may be reduced.

While only a few studies have been performed, results show Chantix works better than a sugar pill (placebo) at helping smokers quit. Researchers found more people were able to remain smoke-free with Chantix. Participants reported reduced withdrawal signs and symptoms and reduced pleasure from smoking. In addition to medication, participants in the studies also received weekly counseling to help them quit.

Chantix also appears to work better than the antidepressant bupropion, though results have been mixed. One study found that Chantix worked better for only the first 24 weeks. Others found Chantix worked better than bupropion for up to a year after participants quit smoking.

Chantix hasn’t been compared with nicotine replacement products, such as the patch or gum, in research studies.

While these results sound promising, keep in mind that the majority of participants taking Chantix in studies didn’t quit smoking. Most couldn’t remain smoke-free for the first 12 weeks of the studies. The percentage of smokers who were smoke-free a year after quitting with Chantix ranged from 14 percent to 23 percent in clinical trials.

For best results, it’s recommended that you start taking Chantix a week before your quit date. Doctors prescribe the pill for 12 weeks — once a day at first, then twice a day. Gradually increasing the dose helps reduce the chance of side effects. If you’ve remained smoke-free after 12 weeks, your doctor may consider prescribing an additional 12 weeks of Chantix to improve your chances of remaining smoke-free.

Be sure to tell your doctor about any history of psychiatric illness before taking Chantix. Chantix may worsen a psychiatric illness even if it’s currently under control. It may also cause an old psychiatric illness to recur.

Participants in clinical trials reported side effects, including:

  • Nausea
  • Headache
  • Vomiting
  • Gas
  • Insomnia
  • Vivid, abnormal dreams
  • Changes in the way food tastes

Some side effects may lessen as your body adjusts to the medication and the withdrawal of nicotine. Taking Chantix after eating and with a full glass of water may reduce the risk of nausea.

The Food and Drug Administration (FDA) issued an advisory in 2008 that healthcare professionals, patients, patients’ families and caregivers should be alert to and monitor for changes in mood and behavior in people taking Chantix. Symptoms may include anxiety, nervousness, tension, depressed mood, unusual behaviors and thinking about or attempting suicide. People taking Chantix should report changes in mood and behavior to their doctor immediately. The FDA also advises that people taking Chantix may experience impaired ability to drive or operate heavy machinery.

Don’t take Chantix if you’re pregnant or are planning to become pregnant, or if you’re breast-feeding. Chantix hasn’t been studied in these situations, so it isn’t clear if it’s safe for these women.

People with kidney problems and those on dialysis may need to have a lower dose of Chantix, so discuss this with your doctor.

Quitting smoking may alter the effects of certain medications and supplements on your body. Tell your doctor about all the medications and supplements you’re taking, especially if you’re taking inhaled insulin, asthma medicines or blood thinners.

For your best chance at quitting smoking with Chantix, you must be committed to your goal. Chantix and other stop-smoking aids may increase the likelihood that you’ll quit smoking, but they don’t make quitting easy. Most smokers try many times to quit. Most try many different medications and strategies, such as counseling, to stop smoking before they finally succeed. Quitting smoking is very difficult and requires planning and persistence, but it can be done.