If youre ready to quit smoking, the good news is there are many stop-smoking options. While some people may opt for nicotine replacement therapies like nicotine patches, nicotine gum, and nicotine spray, if you want to avoid nicotine altogether, there are two prescription drugs that can help: Chantix and Zyban.
Chantix (varenicline) and Zyban (bupropion) are the only two non-nicotine medications approved by the U.S. Food and Drug Administration (FDA) for smoking cessation; both are available in pill form and only by prescription. Chantix received FDA approval in 2006; Zyban was approved in 1997. These drugs can be effective tools, but users need to be aware of some potentially serious side effects.
How Chantix Works
Chantix works by interfering with the receptors in the brain that respond to nicotine. This provides two benefits: It reduces the amount of physical and mental pleasure a person receives from smoking, and it also weakens the symptoms that come with nicotine withdrawal.
Chantix costs about $4 a day to use. Instructions are very specific:
- For the first three days, take one 0.5 milligram (mg) pill in the morning.
- During the next four days, take one 0.5 mg pill twice a day.
- During the second week and thereafter, take two 1 mg doses, one in the morning and one at night.
Always take Chantix after meals with a full glass of water. When taking two doses a day, be sure to wait at least six hours between doses. The recommended length of use is 12 weeks, but that time can be extended another 12 weeks for patients who successfully quit so they can boost their chances of remaining smoke-free.
The Pros and Cons of Taking Chantix
Three points in favor of Chantix:
- Chantix more than doubles a person's chances of successfully quitting smoking.
- Chantix has been proven to be the best smoking cessation aid in preventing relapse and withdrawal symptoms.
- It's easy to use.
Chantix has also been shown to have some serious possible side effects:
- Headaches
- Nausea and vomiting
- Trouble sleeping and vivid dreams
- Agitation
- Depression and thoughts of suicide
Because of possible mood and behavior changes, the FDA recently required the makers of Chantix to add a so-called "black-box warning on the drug label to alert people to its harshest side effects. Requiring such a warning is the most serious step the FDA can take before deciding to ban a drug entirely. An FDA public health advisory warns that Chantix can cause severe changes in mood and behavior and can worsen existing mental illnesses, even when patients are already receiving treatment for mental illness. Patients are urged to talk with their doctor about their psychiatric history before taking Chantix, and to report to their doctor any changes in mood and behavior. Chantix also can affect you while driving or using heavy machinery. The concerns are strong enough that the Federal Aviation Administration has banned pilots and air traffic controllers from taking Chantix.
How Zyban Works
Zyban is an extended-release antidepressant pill that can alleviate nicotine withdrawal symptoms. It works by acting on brain chemicals associated with cravings for nicotine.
Zyban costs on $4 per day and comes with specific instructions:
- For best results, start taking Zyban one week to two weeks prior to your quit date.
- Take 150 mg each day for the first three days.
- From there, many people will increase to the recommended dose of 300 mg per day, taken in two 150 mg doses eight hours apart.
Treatment with Zyban typically lasts 7 to 12 weeks. If you don't show significant progress by the seventh week, treatment usually is suspended.
The Pros and Cons of Taking Zyban
Patients using Zyban are generally successful at quitting, according to research. Zyban has been shown to be particularly effective when used along with a nicotine replacement therapy like the patch or gum.
The pros associated with taking this medication are:
- Its easy to take.
- It contains no nicotine, so there is no problem with toxicity if you still smoke.
- It can be used with other nicotine replacement therapies.
- It can help if the patient is also depressed.
Some of the negatives of this drug are similar to those of Chantix:
- It can cause mood and behavioral changes, and thoughts of suicide. The FDA has also recently required the makers of Zyban to place a back box warning on the packaging because some patients taking it can become hostile or suicidal.
- Zyban cannot be used by anyone who has:
- A history of seizures
- A history of severe head trauma
- A previous or current eating disorder, such as anorexia or bulimia
- A current or past history of heavy alcohol drinking
- Side effects of Zyban include insomnia, dry mouth, and dizziness.
With careful monitoring from your doctor, and if you dont have any pre-existing conditions that would rule you out as a candidate, these non-nicotine based medications might be worth considering.
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