Treatment With Medicine to Help You Quit Smoking
Key Points for This Section
- Feeling depressed.
- Feeling nervous.
- Having trouble thinking clearly.
- Having trouble sleeping.
Nicotine replacement products include the following:
Talk with your doctor before you start any form of treatment. Nicotine replacement products can cause problems in some people, especially:
- Women who are pregnant or breastfeeding.
- Patients younger than 18 years.
- Patients who have the following conditions:
- Heart disease or an irregular heartbeat.
- High blood pressure not controlled with medicine.
- Esophagitis or peptic ulcer disease.
- Diabetes treated with insulin.
- Depression or asthma treated with prescription medicines.
- Patients who keep smoking, chewing tobacco, or using snuff.
The following drugs, which do not have nicotine in them, are used to help people quit smoking:
- Varenicline (also called Chantix). Varenicline is a drug approved by the Food and Drug Administration (FDA) that acts the same way nicotine acts in the brain. In June 2011, the FDA warned that varenicline may increase the risk of heart problems in patients with cardiovascular disease. Other side effects of varenicline include the following:
- Problems sleeping.
- Abnormal dreams.
- Upset stomach.
- Feeling very tired or sleepy.
- Bupropion (also called Zyban). Bupropion is an antidepressant approved by the FDA to help people quit smoking.
- Fluoxetine (also called Prozac). Fluoxetine is an antidepressant and studies have shown that it can help people quit smoking.
These medicines lessen nicotine craving and nicotine withdrawal symptoms.
Fluoxetine causes an increased risk of suicide in adults younger than 25 years. In July 2009, the FDA warned that varenicline and bupropion may cause depression, suicide, and other mental health changes in patients who take them. These changes include:
- Extreme mood changes.
- Psychosis (not being able to recognize what is real or relate to others).
- Hallucinations (a sight, sound, smell, taste, or touch that the patient believes to be real but is not real).
- Paranoia (an extreme fear or distrust of others).
- Delusions (believing something that is not true).
- Homicidal thoughts (thoughts about killing others).
- Hostility (having or showing unfriendly feelings).
- Agitation (inability to relax or be still).
- Anxiety (feelings of fear, dread, and uneasiness that may be a reaction to stress).
- Panic (sudden extreme anxiety or fear that may cause irrational thoughts or actions).
- Suicidal thoughts and attempted suicide.
These mental health changes may occur in patients with or without a history of psychiatric illness and it is not known if nicotine withdrawal is a part of this. (See the Depression and Suicide section in the PDQ summary on Pediatric Supportive Care.)
All patients taking these medicines, especially those with a history of psychiatric illness, should be followed closely by a doctor.
The FDA recommends that the important health benefits of quitting smoking be weighed against the small but serious risk of problems with the use of these drugs.