People’s Pharmacy: Stop-smoking drug triggered despair

Q. I started taking Chantix and was surprised how quickly it cut my smoking in half. I continued with the Chantix until I finally quit.

Depression was slowly creeping up on me, but nothing prepared me for what happened. One day, I woke up feeling as if I’d never be happy again. I have never felt such despair in my life.

I have found it almost impossible to get help. I went to a mental-health facility, but they could do nothing unless I was suicidal and committed myself to their locked facility.

They sent me to the emergency room, but all I could get was a mild anti-anxiety drug. Finally, the cardiologist who prescribed the Chantix called in an antidepressant. I hope it helps.

A. Many people find that Chantix is very helpful in quitting smoking, but the Food and Drug Administration notes that some report the drug can trigger depression, thoughts of suicide or bizarre behavior. Some people suffer from withdrawal symptoms, including depression, when they stop taking the medication. We hope the antidepressant is working.

Q. After taking Aciphex to treat serious heartburn for four years, I developed a severe vitamin B-12 deficiency. I complained to my doctor about being extremely tired all the time. I needed to rest after just a simple task.

I was also diagnosed with hypothyroidism. I had to beg to have my B-12 levels tested, because my doctor didn’t think it was a problem, but we found out it was.

When I contacted the manufacturer of Aciphex, the company seemed uninterested in my experience. Vitamin B-12 levels drop very slowly, so the problem wouldn’t show up in just one year, and studies don’t last longer.

The companies make tons of money on acid-reflux drugs, and I’d like to see them take some responsibility in studying the long-term consequences of these medications.

A. Acid-suppressing drugs (PPIs) like Aciphex, Nexium, omeprazole, Prevacid, Prilosec and Protonix relieve symptoms of reflux. There is a downside, however. Stomach acid is essential for absorbing certain nutrients like calcium, vitamin B-12 and even thyroid hormone (levothyroxine, Synthroid). People who take acid-suppressing drugs long term may be at increased risk for hip fractures.

Cases of vitamin B-12 deficiency have been linked to acid-suppressor therapy (Journal of the American Medical Directors Association, March 2008). Symptoms of this nutritional deficiency include fatigue, confusion and memory problems, peripheral neuropathy, constipation and depression.

We are sending you a copy of our book “Best Choices From The People’s Pharmacy” with more information about treating severe heartburn and tips for discontinuing PPIs. This book is available in libraries, bookstores and online at www.peoplespharmacy.com.

Getting off acid-suppressing drugs can be challenging. Acid rebound can last for months after stopping such medications.

Q. I take lisinopril for high blood pressure and occasionally have a cough that cough syrup can’t touch. My doctor told me that his patients have had amazing success with benzonatate to address this issue. It works for me, too!

A. Thanks for the tip. Benzonatate (Tessalon) is not appropriate for anyone allergic to local anesthetics like procaine (Novocain).

An iron supplement also may help with this kind of cough (Hypertension, August 2001). Switching to another kind of blood pressure medication may solve the problem as well.