
- With Mayo Clinic psychiatrist
David Mrazek, M.D.
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David Mrazek, M.D.
David Mrazek, M.D.
Dr. David A. Mrazek is chair of the Department of Psychiatry and Psychology at Mayo Clinic, Rochester, Minn., and a professor of psychiatry at College of Medicine, Mayo Clinic. Dr. Mrazek has developed a federally funded psychiatric pharmacogenomics research program and implemented clinical psychiatric pharmacogenomics services at Mayo Clinic.
He has received numerous awards including the Award for Creativity in Psychiatric Education from the American College of Psychiatrists and the Agnes Purcell McGavin Award for Distinguished Career Achievement in Child and Adolescent Psychiatry from the American Psychiatric Association. He currently serves as chairman of the board of the American Board of Psychiatry and Neurology.
Dr. Mrazek has focused his current efforts on using pharmacogenomics testing to improve clinical care. One of his specific goals is to decrease the risks of taking psychiatric medications.
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Depression blog
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Sept. 23, 2009
Smoking cessation medications and depression: Be cautious
By David Mrazek, M.D.
It's well known how difficult it is to quit smoking.
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The FDA has issued an alert regarding the use of varenicline (Chantix) and buproprion (Wellbutrin or Zyban). In some cases, people using these medications have had suicidal thoughts and behaviors. That doesn't mean no one should take them, but you should have a discussion with your health care provider if you're taking them, especially if you've been diagnosed with depression or another mental illness. The FDA has warned that in some cases those with psychiatric conditions, such as depression, had more severe depressive symptoms if they were taking these medications.
If you are taking these medications, your provider should monitor you for any emerging symptoms. Stop taking these medications and contact your provider immediately if you experience agitation, depressed mood or any other significant behavior changes.
26 comments posted
February 5, 2012 5:28 p.m.
I was an ex-smoker for nearly 3 years and started smoking again after a very stressful period in my life. I do not wish to go on medications. Instead, I found a very supportive online community of ex-smokers helping me through my quit this time, cold turkey! The site is http://yourjourney.nicoderm.ca/ It has helped lift my spirits, knowing I am not alone in my struggle to stay quit and also knowing I can find support from other members at any time of the day or night. Good luck to each of you!
- deesgirl
October 30, 2011 9:18 p.m.
I have taken a of these particular medications to try and stop smoking. On top of that I have been on one antidepressant or another a small part of each year for the last 5 years. I think I have some specific kind of depression. I have also recently started having panic attacks during times of stress. I want to quit smoking so badly but at the moment when I need a calm moment a find that a cigerette not only calms me physically, as stupid and selfish as this sounds it runs everyone away from me. Its a very peaceful moment.And all other thoughts go right out the window. Please tell me I am not the only one that has been here. I need someone with experience and success to give me some advice on how you became motivated and prioritize your life so you could get this done?
- jamie
October 9, 2011 6:07 p.m.
Tried chantix & the nightmares were just too vivid. Read a book about quitting by Alan Carr.visited the website whyquit.com & quit cold turkey with very little anxiety. Nicotine replacement therapy is not for everyone & I don't believe they are any more successful
- Sue
April 6, 2011 2:43 p.m.
I actually had a great experience with Chantix. I was able to quit and not look back within only two weeks. I have been smoke free for almost four years now. I did experience some mood issues when taking Chantix but my father also passed away at the same time, so I am unsure if it was grief or medicine induced. I stayed on Chantix for the fisrt run of medication and had no problems with side effects. I am so thankful something worked!
- Nikkii
February 21, 2011 10:11 p.m.
Chantix..... Had to quit taking it by the 4th day 'cause I was feeling really suicidal. Wellbutrin.... LOL my smoking doubled when I tried this stuff, just made me crave cigarettes. Oh yea I got depressed too. Ain't modern medicine wonderful?????
- Jim
January 31, 2011 5:48 a.m.
This was a waste of $120.00. I have only taken Chantix for 5 days, but plan on never taking it again. It not only did not affect my desire to smoke, it sent me into rages that were worse on my blood pressure than smoking could ever be. If you have any history of depression, be very careful with adding the Chantix to the mix. As I said, it's only been 5 days, but they have been 5 of the worst days of my life. I'll find another way to quit.
- Donna
November 16, 2010 8:25 a.m.
I used Chantix 2 years ago and experienced not only suicidal depression, but an inability to think. 2 years later I am not depressed, but my mind is still missing nouns. I seriously think it gave me brain damage. It blocks the pleasure receptors in your brain so that means anything pleasurable, so please consider alternative treatment options! google "New York Magazine Chantix" from around 2007 for a scary and accurate account of what will happen to your brain. Although I started smoking again, I had successfully quit for 13 years after an inpatient treatment program. Best way to quit is to go somewhere where it's safe to be irritable and unable to function at least for the fist 72 hours.
- cm
November 3, 2010 11:39 a.m.
wellbutrin caused severe suicidal thoughts for me, requiring hospitalization..Chantix, years later, did the same, but this time I made the connection. Anyone with depression should be wary of these medications. Smoking is an addiction that truly requires more than medicine from which to recover, and for some people, like me, these drugs are deadly.
- lyn
October 10, 2010 3:37 p.m.
be very careful with chantix, when I took it I turned agressive and mean. it changed me, I went back to smoking. I'd rather die of lung cancer than feel like that again.
- don
September 24, 2010 7:05 p.m.
Worsening of depressive symptoms is possible when taking ANY antidepressant. I've had it happen to me (in dramatic and unmistakable ways) twice now. If you find your symptoms worsening significantly on a medication, please be forceful in telling your doctor. And keep telling them until they get it. Wellbutrin was not an issue for me, but Effexor definitely was, as was Prozac in high enough doses. Unfortunately, my doctor just kept increasing my dose when I wasn't happier yet, until I was a very real threat for suicide (which I never was before the meds and never was again). Unfortunately, the worse my depression got, the less assertive I became, so I did not push as hard as I should have to get through to her. Medications are a great and life-changing help for many people, but please do be aware that for a small group of people this is a very real possible side effect. And if you start to think there's a problem, speak up as best you can.
- EmotionalUmbrella
July 20, 2010 3:39 p.m.
This is my second day without a cigar. I've been off cigarettes for several years but had switched to cigars - 5 to 10 / day. God knows how many times I've quit before. 43 days without a single cigar this year with the help of accupuncture and the nicorette patch. I don't have much faith that I can stay quit yet I enjoy the freedom of not smoking. My Doctor prescribed welbutrin - I,ve been on it for 9 days now. No effect yet good or bad. I am very leary of anti depressants. I don't smoke when I travel and when I go and spend week ends at other people's homes and I don't miss it either. Yet every time we come back to the house, I go back to smoking. Cigars are like a constant friend, always there when I need them,I don't have to perform for them and I do not feel judged (really). My wife this morning expressed serious doubt about my new attempt to quit. I had to make an effort not to engage in that one ! So please keep your fingers crossed and I really hope that my desire to not smoke will be with me for ever and that one day I will just forget about cigars and that I will be able to walk a free man. Thanks.
- Chris
May 1, 2010 8:35 p.m.
I had smoked periodically as a teenager, then stopped cold turkey for 17 years. Started up again in 1995. I have tried Wellbutrin which did not work. Also have been on antidepressants on and off since the thyroid disease was diagnosed. When Chantix came on the market, I was one of the first to get a prescription. It works well for quitting smoking but I felt like I felt into an abyss, I couldn't climb out of. I thought it was because I wasn't smoking. Relapsed on smoking and decided to try Chantix once more- didn't last a month until I was back in the abyss and becan having thoughts of suicide. It is now 3 years later and I still am struggling with depression that so far no antidepressant has helped. I'm looking for a good diagnostician who can maybe do more than trial and error in diagnosing my mental health condition. I have Major depression and also believe i have an anxiety disorder as well. I would reccomend that anyone considering Chantix be very cautious and try alternative therapies if you are prone to depression. Lyrica affects me the same way
- Debbie
March 15, 2010 7:23 p.m.
I am 36 hrs. smoke free and really want to do it this time. My father and sister both died at the age of 60 from smoking related illnesses. I also suffer from bi-polar disorder and was scared to death of Chantix as I had already attempted suicide on several occasions. I am using a nicotine patch and a water-vapor only product called smoke assist. I feel strong through prayer and my faith in God and believe He can see me through this. God Bless to all taking on this challenge. Cindy
- Cindy
March 13, 2010 11:30 a.m.
I have been on SSRI's for depression for many years. I also take Lexapro and Wellbutrin as a part of my therapy for Atypical (depressive) Bi-Polar Disorder, which is just a fancy name for depression that varies from bad to worse. I quit smoking July 3, 2007 with the aid of Chantrix and in truth, I don't think I would have been able to quit without it. When I took Chantrix, there was no information available about psychiatric consequences. If I had known what I would go through over the next few months, I would never have taken the drug. By the end of December I was unable to function and was hospitalized. Unfortunately, personal trauma pushed me over the edge further early in January of 2008 and I was re-admitted. The next year cost me dearly emotionally, physically and financially. It is now early 2010 and am finally feeling better. I'm alive to tell about it and I don't smoke now, but the price was heavy. I would advise ANYONE with ANY psychiatric problems to think long and hard before trying Chantrix. As anyone who has ever heard their commercials knows, Chantrix can cause psychiatric disturbances for people who have NEVER had mental illness of any kind. BE CAREFUL!!!
- Paula
February 14, 2010 4:34 p.m.
P.S. Roughtly 2 months after my last cigarette, my anxiety and depression had become unmanageable, and my doctor put me on 150 mgs. of Effexor which he later increased to 225 mgs. This calmed me down and I was able to focus on staying smoke-free.
- Sandra
February 14, 2010 4:26 p.m.
I took Chantix (which is called Champix in Canada where I live) and it helped me to cut down on my smoking (eg. I was able to go a whole work day without taking a cigarette break) and that led to me quitting altogether. (FYI February 17, 2010, marks my 2-year anniversary as a non-smoker.) The nicotine withdrawal was nothing compared to the emotional withdrawal...you are bound to have some grief when you give up these little white sticks that have been your constant companions for the better part of 30 years. So I stand firm in my belief that it isn't the Chantix or other drug that makes people "a mess", it is the absence of cigarettes in their lives that is responsible. Nicotine addiction is only part of your love of smoking; it is a psychological addiction as well. Why else would you continue engaging in a habit that costs a lot of money, makes you and your home stink, and will likely give you lung cancer or emphysema? Take the time to do some soul-searching before your next attempt to quit...ask yourself what cigarettes really mean to you, what are they replacing, what are you not facing?
- Sandra
January 26, 2010 4:43 p.m.
I tried wellbutrin at one time to quit smoking. After the 2nd week on the stuff, I began to have feelings of abject hopelessness which I guess was depression. It was so bad that I quit the stuff and have never taken anything else. I still smoke and still setting the goal with ever cigar I smoke that it will be my last. However, I've read to not be too hard on myself and to keep trying and that's what I've been doing seems like forever now. These things are going to kill me if I can't beat them.
- larry
January 25, 2010 9:50 a.m.
I took Chantix last January to quit smoking. I was on Lexapro at the time and was able to stop smoking, but it took my anxiety and depression into hyper-drive. I am now on Pristiq/Chlonopin and am nor doing well at all. Plus, I started smoking again. Stay away from Chantix if you have any doubts about how it will affect you. It has made a mess of me.
- CAM
January 5, 2010 9:57 a.m.
I took Chantix about 3 years ago to quit smoking with tremendous success. I had not side effects whatsoever with the exception of vivid dreams. Unfortunately I started smoking again due to some personal issues after almost a year and just recently quit again. This time around I had ALOT of side effects from the Chantix...anxiety, depression, EXTREME irritability, and not listed - major chest pain (1 ER visit, thousands of dollars worth of chest and nothing is wrong) . I had to quit taking it after just 3 weeks. It did help me to quit smoking, but I could not continue to take it. I always thought people over exaggerated the side effects of Chantix. I mean, you are QUITTING SMOKING, of course your are going to be irritable, depressed, etc. I learned this time around, however, that these side effects can be very real. Don't know how it is that it effected me so intensely this time and not the last, but I do know both my parents took it and it worked wonders for them with absolutely no side effects at all. Bottom line, it can be a miracle drug for some but pretty bad for others sometimes. After just 3 days of quitting Chantix I felt a marked improvement in my mood...and have not started smoking again. I do credit Chanitx with helping me in my initial quit week, though. If you decide to take Chantix, just pay close attention to your mood and stop taking it if this happens to you.
- Jessica
December 31, 2009 5:02 p.m.
I AM TAKING PRISTIQ FOR GENERALIZED ANXIETY & HAVE A PRESCRIPTION FOR CHANTRIX TO QUIT SMOKING; I WOULD LIKE REASSURANCE THAT THESE TWO DRUGS WILL NOT CAUSE ADVERSE INTERACTIONS. PLEASE ADVISE.
- MARIE
November 10, 2009 7:52 a.m.
I wonder if the new personal vaporizers could help? I have researched them and they seem like a potentially powerful tool for smoking cessation, however, the existing eliquids are possibly over purified. The liquid contains only the nicotine and the other alkaloids are processed out. The result is that some smokers still have problems quitting altogether while others have no problem and some even quit using any nicotine in them. Possibly someone here could weigh in on the reason for that and the possible benefit to those trying to quit smoking.
- frankie
October 14, 2009 7:33 p.m.
After a hysterectomy 10 years ago, I was put on depression medication in leu of estrogen. I used Chantix (for 6 weeks) 3 month ago, and I am a walking disaster. The chemical imbalance that my brain has created from Chantix, Lexapro, other meds. and the lack of nicotine in my system has turned my life inside out. I don't know who I am anymore. I became severely depressed, I was in the hospital for shortness of breath, blood pressure was high, chest pains etc. All checked out. I now have panic attacks, I can't think straight, it is effecting my work and my personal life. I have had suicidle thoughts but too stubborn for this to take me down. Yet I only have questions and no one really has answers. God Bless all of you and remember this: With addictions of any kind, we fight the same battle and it starts in our mind.
- Bonnie
October 14, 2009 1:15 p.m.
While I was not aware any increase in depression I did experience severe chest pain. Contacting Cantix providers I was told there had been other reports of chest pain . Be aware.
- Lynn
October 6, 2009 2:52 p.m.
10-07-09 Thanks for the warning on the products to stop smoking. I successfully quit in 1975 and did it by fasting, sweating, and water. It was rough a few days thereafter, but I continued with determination. There is no excuse for smoking something that can addict you to kill you. However, I did not know these products like Zyban could cause a person suicidal tendencies. Here is another one:Suppra. I just completed a food workshop. The product is made allegedly from cow milk and is better for us than those chemical sweetners? Suppra also can cause depression, and a few other things as well. Compound THAT with the zyban that causes the depression and you could be finishing the killing that the cigareetes were doing to you in the first place!
- Valerie
September 30, 2009 11:26 a.m.
My husband has had a heart attack and a stroke and still smokes. He used Wellbutrin under the name Zyban to help him quit smoking before and it improved his mood tremedously. He was clinically depressed at the time and didn't know he was taking an antidepressant. Now after the stroke I'm afraid for him to try Wellbutrin again since it has a small chance of causes seizure. So does the brain damage from his stroke. Not a good mix. A therapist has been recommending the Chantrix to him, so I'm glad to see some information on it. Marcia is right, nicotine is a powerful addiction. It took our doctor 5 times to quit. I don't allow my husband to smoke in the house or anywhere around me. I'm sensitive to the smoke, and yes it stinks and when it's humid, it clings to his clothing. Sometimes I tell him to go back outside and air himself off. Quitting isn't easy. That's why there are so many products on the market to help smokers. But they have to be willing and ready to quit. My husband is down to 2-3 cigarettes/day. To me it seems silly not to quit now. But it's his body and his lungs. Just keep it away from me.
- Anita

26 comments posted