San Antonio Express-News (Sunday)
Stop-smoking drug led to prolonged depression
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 Food and Drug Administration 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 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.”
Q: I have lived with hypothyroidism all of my life. My TSH levels correlate closely with how I feel: I’m best when TSH is under 2. I start to notice the following when it gets up to 4: cold hands and feet, foggy thinking, depression, weight gain and fatigue.
Two internal medicine doctors and a pharmacist have told me that TSH levels should be under 2. I strongly believe that, too, based on years of personal experience. Also, I believe that there is a connection between low vitamin D levels and hypothyroidism. Getting my vitamin D to a normal level helped change my life.
I am a full-time office worker and mother of three with healthy exercise and eating habits. I hope my experience will help others.
A: Thank you for sharing this advice. Endocrinologists generally consider that TSH above a level of 2.5 to 4.5 indicates hypothyroidism. That’s because TSH (thyroid stimulating hormone) goes up when thyroid hormone production goes down.
Although it is not common knowledge, your observation that vitamin D could be helpful is plausible. There is preliminary evidence that low levels of vitamin D may contribute to an underactive thyroid gland (Galen Medical Journal, May 21, 2020).
You will find much more information about the diagnosis and treatment of thyroid conditions in our “eGuide to Thyroid Hormones.” This online resource may be found under the Health eGuides tab at PeoplesPharmacy.com. Q: Will an antacid like Tums interfere with the efficacy of an antibiotic?
A: Everything depends upon the antibiotic. Tums contains calcium carbonate. This mineral can interfere with the absorption of tetracycline-type antibiotics such as doxycycline, ciprofloxacin (Cipro), levofloxacin (Levaquin) and norfloxacin (Noroxin). You should separate the antacid from the antibiotic by a couple of hours to be on the safe side.