The stop-smoking drug varenicline (Chantix) was first approved by the FDA on May 11, 2006. It wasn’t long before millions of people were taking this oral medication to help them quit cigarettes. The idea that a pill could reduce the craving for nicotine was very attractive to smokers who had tried to quit unsuccessfully. But there was one side effect that many people did not anticipate. Could Chantix cause depression? If so, would it disappear as soon as the drug was discontinued?
Did Chantix Cause Depression That Persisted?
We received this message from a visitor to this website:
Q. More than 15 years ago, my doctor prescribed Chantix to help me quit smoking. Instead, I became desperately depressed.
After taking the drug for two weeks, as prescribed, I had my last cigarette on July 4. By mid-July, I felt horrible. I barely dragged myself out of bed to spend the rest of the day on the couch.
I was determined to finish the prescription but even after I stopped the medication, I was depressed. I had no appetite and lost interest in previous passions like fishing.
I also had no interest in sex, but I handled my (unloaded) handgun much more than usual. According to my wife, I turned it over and over in my hands. She is a skilled nurse who took that as a red flag and wisely hid the gun. I haven’t seen it since.
No drugs have gotten rid of the depression that started with Chantix. I have taken Prozac, escitalopram and Buspar, and still I keep hoping for a safe and effective antidepressant! Please warn your readers about this potentially lasting side effect of Chantix.
A. At one time the FDA required a black box warning in the official prescribing information for varenicline (Chantix). It warned about serious side effects including:
“depression, suicidal ideation, suicide attempt, and completed suicide.”
The black box has been removed, but the warning remains:
“…neuropsychiatric adverse events have included changes in mood (including depression and mania), psychosis, hallucinations, paranoia, delusions, homicidal ideation, aggression, hostility, agitation, anxiety, and panic, as well as suicidal ideation, suicide attempt and completed suicide.”
Does Chantix Cause Depression?
There has been a lot of controversy about the question of could Chantix cause depression. A meta-analysis of 13 systematic reviews and 46 randomized controlled trials in the Journal of Addiction Medicine (May 3, 2023) reported:
“The common adverse events were nausea, vomit, abnormal dreams, sleep disturbances, headache, depression, irritability, indigestion, and nasopharyngitis.”
A Dutch study contradicted these findings, though. Researchers analyzed the use of varenicline and its relationship to the prescribing of neuropsychiatric drugs (Pharmacoepidemiology and Drug Safety, Feb. 2022). The authors were looking for signs of depression or anxiety. The conclusion:
“Varenicline initiation was unlikely to be associated with an increased risk of taking anti-depressants nor anti-anxiety drugs.”
This contrasts with a study published in PLoS One, Nov. 2, 2011:
The authors analyzed data from the FDA’s Adverse Event Reporting System from 1998 through September 2010. They reported:
“Overall we identified 3,249 reported cases of suicidal/self-injurious behavior or depression, 2,925 (90%) for varenicline, 229 (7%) for bupropion [Zyban], and 95 (3%) for nicotine replacement. Compared to nicotine replacement, the disproportionality results (OR (95% CI)) were varenicline 8.4 (6.8–10.4), and bupropion 2.9 (2.3–3.7).”
“Varenicline shows a substantial, statistically significant increased risk of reported depression and suicidal/self-injurious behavior. Bupropion for smoking cessation had smaller increased risks.”
Making Sense of Confusing Data:
We cannot answer the question: does Chantix cause depression? That’s because there is research that says yes and research that says no. In such instances, we pay attention to the FDA official prescribing information that warns about:
“…changes in mood (including depression and mania), psychosis, hallucinations, paranoia, delusions, homicidal ideation, aggression, hostility, agitation, anxiety, and panic, as well as suicidal ideation, suicide attempt, and completed suicide.”
It goes on to encourage health professionals to:
“Observe patients attempting to quit smoking with CHANTIX for the occurrence of such symptoms and instruct them to discontinue CHANTIX and contact a healthcare provider if they experience such adverse events.”
We think that is good advice!
Another reader wants to know can Chantix cause depression?
Q. I am taking Chantix to quit smoking. I have had no urge to smoke, but I am seriously depressed.
In the past I was diagnosed with depression and anxiety. I attempted suicide 10 years ago and was hospitalized for depression.
I am concerned that my recent bout of severe depression may be a result of taking Chantix. Has this topic been researched? I want to stop smoking but I don’t want to be this depressed. I am still seeing a therapist. Should I tell him about this?
A. Chantix works in a completely different way from nicotine replacement gum, lozenges and patches.
In clinical studies Chantix was somewhat more effective than another oral medication, Zyban (bupropion SR), in helping people stay off cigarettes.
The most common side effects of Chantix are nausea, headache, sleep problems and strange dreams. Although depression is not listed as a common side effect, it was frequently reported among people who participated in the clinical trials.
Please contact your therapist about your depression. Your doctor may consider whether Zyban, which also has antidepressant activity, might be more appropriate for you.
There are more reports of Chantix side effects in the comments below. If you have ever taken varenicline (Chantix) to quit smoking please share your experience in the comment section. 1) Did it work? 2) Were you able to successfully quit smoking? 3) Has the success lasted? 4) Did you experience any side effects? 5) If so, please describe them.