Doctor Finds Success With Chantix

By Nancy K. Crevier

Chantix. The drug has an almost dreamlike quality to its name, and according to Dr Diane Wenick of Danbury Medical Group, Chantix truly is a dream come true when it comes to helping smokers quit smoking.

“In all my 20 years of practice, I’ve had more smoking patients quit smoking [who have tried Chantix] in the past year than the rest of the 20 years put together,” said Dr Wenick.

Dr Wenick and the other doctors in the Danbury Medical Group have prescribed Chantix for nearly a year, said Dr Wenick, with a success rate of between 80 to 90 percent.

Varenicline, marketed in the United States as Chantix by pharmaceutical company Pfizer Inc, works by blocking nicotine from attaching to receptors that signal the release of the chemical dopamine into the body. Dopamine induces a feeling of well-being and pleasure. When nicotine cannot attach to the receptors, smokers experience no pleasure from smoking and the desire to smoke is alleviated or entirely dismissed.

“When a patient is taking Chantix, smoking doesn’t do anything for them,” said Dr Wenick, “even as soon as a week after beginning the program.”

Pfizer recommends using Chantix for a six-month period, but Dr Wenick has found that many of the 15-plus patients she has treated were doing fine after just three to four months.

“Smokers use the ‘start pack’ for one month, then build up the dosage. I give them a continuing pack with three refills, and that seems to be working,” she said.

If Chantix is such a wonder drug, why are more smokers not knocking down the doors to get a prescription? There are a few reasons. “People just don’t know about it,” said Dr Wenick. Direct to consumer television ads began the week of September 23, something that Pfizer representatives had told Dr Wenick would be occurring. “I think the direct to consumer advertising will be a really good thing,” Dr Wenick said. “I have had patients say to me, though, ‘I told my friends and they went to their doctors for a prescription and now they’ve quit, too.’”

Patients also fear the cost, said Dr Wenick, and not all insurance companies presently cover the approximately $130 a month for the prescription.

“But there are studies that show that in Connecticut it costs smokers $5.34 per day to smoke. For a one-pack-a-day smoker, that means $487 over 12 weeks. Twelve weeks of prescriptions for Chantix costs about $410. So when they tell me they can’t afford it, I just tell them, ‘Yes, you can.’ And I think more insurance companies are beginning to consider paying for this drug,” said Dr Wenick.

At the website for the US National Library of Medicine and National Institute of Health, side effects listed for varenicline include nausea, constipation, gas, vomiting, heartburn, bad taste in mouth, appetite changes, trouble sleeping, abnormal dreams, drowsiness, headache, and rash. It is hardly appealing, but Dr Wenick said that her experience has been that of these side effects, it is primarily nausea that her patients complain about when taking Chantix.

And even that is more often mild than not, with a positive spin to it: “One of the biggest complaints that smokers have about quitting is that they gain weight. It may be that the mild nausea can prevent some of that weight gain, so it isn’t all bad,” she said. One or two of her Chantix patients has complained of insomnia or nightmares and just one found that the nausea was intolerable. In any case, Dr Wenick feels that three months of feeling a little uncomfortable is worth the long-term benefits of quitting smoking.

“The risk of heart disease, the risk of stroke, the risk of numerous types of cancers, and emphysema are all decreased when a smoker quits smoking, and that happens rather quickly,” explained Dr Wenick. “Smokers who quit feel better overall, both mentally and physically. They feel better about themselves. They are so happy to come in to me and say, ‘Guess what? I quit.’ Some of my patients that I have been badgering to quit for 20 years have been able to quit with Chantix.”

Success!

One of those patients long pestered by Dr Wenick to stop smoking is Sandra Thomas of Brookfield. Until May 19, she had smoked every day of her life for 48 years, except for one year when she quit cold-turkey.

“This pill is fantastic,” said Ms Thomas, who feels confident that she will not start smoking again. “I don’t know exactly how Chantix works, but even around other smokers, I have no desire to smoke anymore. It amazes me.”

She had known for years that her emphysema was aggravated by her smoking, said Ms Thomas, and finally decided that she was jeopardizing her chances of seeing her grandchildren grow up and get married by continuing to smoke.

“Dr Wenick suggested Chantix and it worked. I stopped taking Chantix after just five weeks. Cigarettes started to taste real bad and it becomes a waste of money. You light a cigarette, take drag, and throw it out.”

The only side effects Ms Thomas experienced with Chantix were bloating and “some crazy dreams. But both went away when I stopped taking the drug. It’s a great pill. To me, it was a godsend,” said Ms Thomas, who has been pivotal in getting two of her own friends to quit using Chantix.

Another patient, who requested anonymity, had smoked for more than 40 years before trying Chantix last November.

“I was skeptical,” he said. “My wife had heard of Chantix, so I asked Dr Wenick about it when I went in for a checkup.” A CAT scan that summer that showed a 40 percent blockage of one carotid artery had convinced him it was time to quit smoking, once and for all. He had tried to quit many times in his smoking career, but always went back to it.

“I found quitting smoking quite easy this time. For some reason, by the time my quit date came, I didn’t even want to smoke.”

As part of the Chantix plan, smokers designate a “quit date,” start the drug, and can continue to smoke until they reach that date — if they still want to. Most, like this patient, find that they are more than ready to stop smoking by their quit date.

What is needed in addition to losing the pleasure of smoking is replacing of habits that trigger smoking, said this patient.

“You need to start doing things differently so that there’s no association with smoking,” he said. “Like if you used to have a cigarette while driving to work or after walking the dog, you need to alter that habit and substitute a new one. But that’s easier with no nicotine desire.”

Nor was nausea a problem for this patient during the three months that he took Chantix. “I had some very vivid dreams, but it was kind of fun. I’m not one who usually recalls my dreams, but these were memorable. And I felt good when I woke up.”

Will he return to smoking after nearly a year of smoke-free living? “I hope not, but I don’t know. I don’t think any drug taken for a short period of time will prevent you from doing something foolish in five years. But I would use Chantix again. I’m leading a healthier lifestyle now and I want to keep it that way.”

According to a July Associated Press article, varenicline may have a future treating excessive drinking and other addictions, as well. It is suspected that alcohol also acts on the same receptors as nicotine and that varenicline may be able to depress the desire to drink or partake in other addictive behaviors.

“Chantix has not been indicated yet to prevent excessive drinking,” said Dr Wenick. “The studies on that are just starting. It would be pretty impressive if it did work, though.”

Because counseling and support is important in conjunction with any attempt to quit smoking, Dr Wenick suggests Chantix patients visit chantix.com or call 1-877-CHANTIX for information on the Chantix GetQuit support group. Regular e-mail or phone check-ins and a cravings hotline are part of the support program and can help patients navigate the difficult early days of an antismoking program.

Quitting smoking is one of the hardest challenges a smoker can face, said Dr Wenick, but varenicline offers the best chance for success, she believes. Chantix is appropriate for nearly any smoker who really wants to quit smoking, said Dr Wenick.

“I’m a big advocate of this drug and so are my partners. [Chantix] will help smokers more than anything we’ve had in the past. We have used Zyvan and patches, and they just don’t work as well. All of my smoker patients who express any interest in quitting, I give them a prescription for Chantix. It empowers them to make that decision,” she said.