Varenicline tartrate (Chantix, Champix) is effective in helping smokers stop smoking. Unfortunately, ome patients may have significant adverse psychiatric effects while taking the drug.
Mechanism: alpha-4, beta-2 selective nicotinic acetylcholine receptor (nAchR) partial agonist
Patients with pre-existing psychiatric disorder are at increased risk, but these reactions may occur in patients without any prior history of comorbid psychiatric disorders.
Adverse effects include:
(1) worsening of depression or anxiety
(2) suicidal thoughts or actions
(3) violence towards others and/or hostility
(5) bizarre and vivid dreams
(6) changes in behavior, including mania
(7) agitation or restlessness
(8) mental confusion
(1) effects of nicotine withdrawal
(2) pre-existing mental disorder
Varenicline is implicated if the symptoms appear or worsen while on varencline but disappear or improve when it is stopped.
Karam-Hage et al reported a patient whose symptoms improved by the addition of buproprion SR while taking varenicline.
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