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US Health Service’s Chantix Recommendation is Disturbing

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The US government is promoting Chantix, Pfizer Inc.’s smoking cessation drug, even though recent reports have linked it to suicide and other psychiatric side effects.  What’s worse, the lead author of the new US Public Health Service guidelines that tout Chantix was once a paid consultant to Pfizer.

Though the new guidelines do note that Chantix has been linked with suicide and other psychiatric side effects, they claim  the Pfizer drug is  the method most likely to help smokers wanting to quit. But critics say Chantix has not been on the market long enough to known the true extent of its suicide risks, or what other side effects it might carry. Others have questioned the role of  Dr. Michael Fiore in writing the guidelines, which they characterize as little more than a Chantix sales pitch. Fiore was once a paid consultant to Pfizer. Though Fiore says he cut ties with Pfizer in 2005, critics say those ties could still cause him to be biased in favor of Chantix.

According to the Associated Press, the new guidelines encourage doctors to speak with their smoking patients about Chantix, and claim it works better than other methods or drugs. The guidelines say doctors should consider asking about their patients’ psychiatric history before prescribing Chantix. Doctors also should monitor patients for changes in mood and behavior while on the drug.

But some smoking experts question claims that Chantix is more effective than other smoking cessation methods. Lois Biener, a researcher of tobacco use and smoking cessation efforts at the University of Massachusetts in Boston, told the Associated Press that most people who quit do so without smoking essation drugs. While a few studies have shown some benefit, it’s “way less than what is claimed” by medication advocates, Biener said.

Chantix, approved in the US in 2006, works by blocking nicotine receptors to the brain. Chantix is the first such nicotine receptor partial agonist approved by the FDA. It was heralded as an alternative to other smoking cessation drugs and nicotine replacement therapy.In the US, 34 Chantix users have reportedly committed suicide.  In February, the FDA said “it appears increasingly likely that there may be an association between Chantix and serious neuropsychiatric symptoms.”

The agency said that it had asked Pfizer to elevate the prominence of safety information regarding suicidal thoughts and other psychiatric problems to the warnings and precautions section of the Chantix prescribing information, or labeling. In addition, the FDA said it was working with Pfizer to finalize a Medication Guide for patients. However, many consumer advocates, including the group Public Citizen, want the FDA to go further and highlight the Chantix suicide risk with black box warning – the agency’s highest safety alert.

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