Champix: Is This Smoking Pill Safe?
|The Daily Mail||
22 Jan 2008
When Karen McGhee woke up in a hospital bed and saw her teenage daughter looking anxiously at her, she was completely flummoxed.
"My arm was bandaged and the left side of my mouth and neck felt numb, as if I had been to the dentist - but I had no idea why I was in hospital," says the 38-year-old.
"Then Jenna told me I'd tried to kill myself. She said her nine-year-old sister, Aynslie, had found me in the middle of the night hanging from the banisters with the pelmet from the curtains tied around my neck."
Karen listened in horror as her daughter recalled how she had turned blue through lack of oxygen, and her heart stopped five times in the ambulance on the way to hospital.
The doctors were convinced Karen had brain damage, and after three agonising days her family had decided to turn off her life support machine. She was expected to die within minutes, but instead miraculously began to breathe on her own.
With absolutely no memory at all of what she'd done, Karen says her daughter's account of what had happened was like hearing about another person.
"My last recollection was of being extremely happy," she says.
"Just weeks before I was feeling blessed that my husband Robert had survived a heart attack. I was looking forward to the rest of our lives together."
In fact, the mother-of-three from Greenock, Scotland, had developed severe depression and tried to hang herself after taking Champix - a pill designed to help reduce nicotine withdrawal symptoms and stop cravings.
Yesterday, the Mail reported how Wayne Marshall, a 36-year-old father-of-two from Doncaster, was found hanged shortly after completing a 13-week course of the same drug.
Last October, TV editor Omer Jama, 39, committed suicide after starting using Champix.
Medical watchdogs are being urged to investigate the drug to ensure it is safe to use.
The drug works by binding to nicotine receptors in the brain. Nicotine stimulates the production of dopamine, which is the "pleasure" chemical in the brain.
By attaching itself to the receptors normally used by nicotine, Champix fools the brain into thinking it's had nicotine - so satisfying the craving for a cigarette.
The drug has a good success rate. After 12 weeks, 44 per cent of those taking Champix have given up smoking.
However, since the drug's launch in Britain in December 2006, the Government's drug safety watchdog, the Medicines and Healthcare products Regulatory Agency (MHRA), has received 1,513 reports of adverse reactions, including 62 reports of suicidal feelings.
As Jenna told her mother what had happened, Karen began to wonder if the medication she'd been taking in the weeks up to the fateful event had played a part in it.
"After Robert's heart attack last July, his consultant recommended Champix to him," she says. "He smoked 60 a day and had never been able to quit.
"I decided I would also try to quit my 20-a-day habit. My husband's heart attack had hammered home to me just how dangerous smoking can be."
The couple were given a standard 12-week course of Champix tablets and told to try to give up cigarettes ten days into the course.
Sure enough, when Karen lit a cigarette on the tenth morning, the taste made her want to vomit, as did the second cigarette she tried. The next day she didn't want a cigarette, nor did she have one.
Robert, meanwhile, continued to crave cigarettes and continued smoking, albeit cutting down from 60 a day to 20.
"I was delighted that giving up was so easy," says Karen. "In fact, it seemed almost too good to be true. I had tried willpower, nicotine patches and gum in the past - but each time had started smoking again within 48 hours."
However, just days after starting on Champix, Karen realised something wasn't quite right.
"I started to feel really grouchy all the time, and would shout and scream at my family for no good reason, which is totally out of character."
Indeed, she became so moody that even her mother-in-law noticed something was wrong and suggested she should stop taking the pills. But Karen thought it was probably nicotine withdrawal that was causing the problem - and so continued.
However, she began to feel even worse. "I started being sick about three times a day," says Karen.
"Looking back, I was stupid to think it was because I'd quit smoking, but I'd had no idea what to expect.
"I also became really depressed. I felt so low that I couldn't see the point in doing anything. Normally, I am an active person, but I started spending the whole day slumped on the sofa. I had no enthusiasm for anything."
Karen had suffered from mild depression on and off for the past 20 years and started taking antidepressants in 2005. However, she says Champix made her feel lower than ever.
In September, just under two months after she'd started taking the drug, her husband became very concerned.
"Robert said he wanted his wife back - and pleaded with me to stop taking the tablets," says Karen.
He was so worried by the effect the pills were having on his wife that he had stopped taking them himself. He had also become irritable.
Despite this, Karen was still convinced the pills were not the problem, and put her symptoms down to nicotine withdrawal.
"I was so low that my mother said to me: 'I would rather you started smoking again than continue like this'." she says.
"Robert kept trying to do things to cheer me up, such as taking me out for dinner, but I could not shift this deep depression. I did not bother talking to my GP about it because I thought it was just something I had to endure after giving up smoking."
On October 17, following a meal out, the family went to bed as normal. The next thing that Karen remembers is waking up in hospital.
The following day a psychiatrist came to see her. Karen says: "Robert showed him the Champix and said : 'Do you think this made her do what she did?' The psychiatrist said: 'It won't have helped'."
Karen stopped taking the pills immediately. She was kept in hospital for a week, where her mood improved drastically. Her husband said he felt as if the "old" Karen had come back.
She now has a six-inch scar on her arm where it was burnt on the radiator during her suicide bid. But the mental scars are much deeper. Her daughter Aynslie is so traumatised by what happened that she refuses to go up the stairs alone.
"I try each day to be as nice to my children as possible, to make up for what I put them through," says Karen.
"Aynslie said to me recently: 'Don't feel guilty about what happened, Mummy. It wasn't you - it was the pills'.
"I am convinced Champix is to blame for what happened to me.
"A week after my suicide bid, I opened the paper to read about Wayne Marshall, who did kill himself after taking Champix.
"It sent chills though me. It could so easily have been me, and the idea of leaving Robert and the children is just unthinkable.
"I am ashamed to say that a week after leaving hospital, I started smoking again. No one has criticised me for it. They would all rather have me smoking than dead.
"I suspect I will smoke for the rest of my life. After everything that has happened, I am just too frightened to give up."
Dr Alex Bobak, a GP from Wandsworth, is the only doctor in the country to have a specialist interest in smoking cessation and has helped conduct trials on Champix (though he is not paid by the makers).
He believes the drug is safe.
"I am convinced it is giving up smoking, and not the effects of Champix, which have caused some people to feel suicidal," he says.
"Without nicotine, many people do become irritable, grouchy and depressed - even suicidal.
"This is because nicotine stimulates the production of dopamine in the brain, a chemical which induces feelings of happiness. Without it, some people can become down.
"Interestingly, in trials on people trying to quit smoking, those taking Champix reported feeling much less irritable and depressed than those taking a placebo pill.
"I think that for most people Champix does help reduce all the bad feelings, but for some people - and I believe only a small minority - it does not do this enough.
"I would urge people not to be put off taking this drug. Remember, more than 50 per cent of long-term smokers will die prematurely as a result of a smoking related disease."
Pfizer, the makers of Champix, said in a statement: "We are working closely with the EMEA ( European Medicines Agency) to review reports of depression and suicidal thoughts in patients attempting to stop smoking and taking Champix.
"There is no scientific evidence establishing a casual relationship between varenicline (Champix) and these reported events."
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