Taking a Chance on Chantix
Jul 05, 2011 5:42 AM EDT
Thank you for pointing out how little doctors actually know about the drugs they prescribe. Our system is flawed. Providers learn about drugs from marketers who work for drug companies. These drug representatives sing the praises of their drugs & ignore concerns. In 1953 research showed DES did not prevent miscarriage but drug reps pushed it hard anyway, so DES was heavily prescribed until 1971 - to the harm of the DES-exposed mothers, daughters, sons and now possibly grandchildren. Patients don't realize their doctors are going on the word of drug makers when they assure the safety of the prescriptions they write!
- Fran Howell
Jul 05, 2011 5:49 AM EDT
Thanks, Fran. I'd often accompany my mother-in-law to physician appointments, where I would be treated like a mental defective if I dared ask a question. I couldn't believe how vehemently this man was pushing the drug -- and my mother-in-law is from a generation when physicians were never questioned.
- Ricki Lewis
Jul 05, 2011 4:39 PM EDT
Found this blog post from a twitter re-tweet. Nice job on this post. I will probably do a quick video blog on this topic in the next day or two myself.
The problem with this new cardiovascular scare is two-fold. For one, the numbers a pretty small. I think it is too early to react too much to this particular concern. Secondly, the cardiovascular risk of smoking itself is well established and more significant than the numbers we are seeing from this Chantix data.
While I think there is due cause to raise a big caution flag with Chantix given the numerous postmarketing health concerns, I am surprised at the ardent conclusion by the study author that this drug should be pulled from the market. Perhaps this is a result of a growingly cautious environment resulting from postmarketing disasters with other medications.
We know, at least as far as the literature has shown, that Chantix is the single most effective intervention in smoking cessation. Given the multiple severe consequences of continued smoking, I think it would be prudent to await a clearer picture before writing Chantix off as a smoking cessation option. Perhaps it will no longer be an appropriate first line option for many patients, but the medication choices are quite limited.
And yes, everyone should receive counseling! This was a big part of the Chantix trials, and could very well be the reason the quit rates were greater than other medical interventions. But it is pretty clear that addition of medicine (nicotine replacement, buproprion, Chantix, or a combo of the first two) results in a greater chance of smoking cessation.
Aaron Emmel, PharmD, BCNSP
Jul 05, 2011 6:14 PM EDT
Hi, Aaron, thanks for your comment! I agree that it is too soon to pull Chantix from the market -- the mechanism makes sense and it works. I call my blog Genetic Linkage because I like to link things, and I was intrigued by the Chantix report coming on the heels of the release of the cigarette packaging photos, and just before the Lancet texting study.
I begged my mother-in-law to call for the Chantix support. It was a little like prescribing an anti-depressant without any counseling. My beef was more with the doctor prescribing it than with the drug.
I really appreciate your response (I'm rather new to blogging and tweeting) and will continue to watch developments in this area. The addictive power of nicotine is truly frightening.
- Ricki Lewis