My husband has smoked for many years, and has tried quitting a dozen times. He has tried quitting cold turkey, tried cutting back gradually to nothing, he has tried the gums and the patches. Every time, he would do okay until he got about a month or so in, and then he would begin having bursts of anger. He felt angry and irritable all the time, and the tiniest thing could set him off on a rampage, and eventually he would become very depressed. He hated feeling that way more than he hated smoking. Eventually, he would go back to smoking just so he could feel normal again.
When my husband and I heard about a new pill called Chantix that is supposed to help people quit smoking, we quickly got in line to get a prescription. We had been to the website and read how Chantix works differently than the patches or gums. Patches and gums contain nicotine, which is supposedly the addictive substance in cigarettes. Most patches and gums work on a “step-down” program, where when starting out, they contain the highest levels of nicotine, and as you use them over a period of weeks, they contain less and less nicotine until you’ve been weaned off nicotine and you are now a non-smoker.
Chantix works differently. It contains no nicotine. Instead, the pill blocks the nicotine receptors in the brain. Nicotine, when introduced into the brain, stimulates the production of dopamine, a naturally occurring chemical. Dopamine works similarly to serotonin and is contributes to an individual’s feelings of happiness and well-being. In addition to not containing nicotine, Chantix contains dopamine. It sounded like Chantix offered a one-two punch: it weaned you off the addictive nicotine while supplying the brain with extra dopamine to help even out the lows often experienced when trying to quit. Maybe this was the answer, the thing that would get my husband through the rough patch of anger, irritability and depression he experienced every time he tried quitting before.
We got the prescription filled and anxiously crossed our fingers. Aside from nausea and vivid dreams, the Chantix seemed to have few side effects, and it did wonders for cutting down the cravings for a cigarette. In fact, my husband began going for days without even thinking of cigarettes. When he was on the patches or gums, cigarettes were never far from his mind. But the Chantix killed the thought of cigarettes and he did not express any interest in them at all. We were hopeful; it seemed like the Chantix was working.
While he was taking the Chantix, we kept a daily tab on his emotional level so we could carefully monitor how he was feeling. All too often before, the anger and irritability slowly set in without us noticing until it had gotten really bad. We didn’t want that to happen this time, so we marked on the calendar every day how he was feeling.
We were going along smoothly and were almost through with the 12 week treatment program when we started wondering what would happen when he no longer needed to take the Chantix. Up until now, he’d been getting by on higher than normal dopamine levels. When the Chantix ran out, would he experience a crash? We would soon find out, but not before the worst side effect he’d ever experienced happened.
Before the 12 weeks were up, my husband became very delusional and paranoid. Extreme paranoia set in and he began having suicidal thoughts. I knew things were very, very bad, because my husband was never the type to think about suicide; in fact he has an extreme fear of death. Without waiting to consult a doctor, he stopped taking the Chantix. Within a week, his paranoia and delusional thoughts vanished, as did our hopes that Chantix would be the miracle cure.
We started our own little research project to see if we could figure out what had happened. Why would Chantix cause such a severe emotional reaction? We looked at how Chantix differed from other quit-smoking alternatives. First, it contained no nicotine. Fine, we knew that lack of nicotine or a lesser amount than the body is used to can cause irritability and depression. But why? Well, nicotine raises the amount of dopamine in the brain. If a person were to get used to running on higher than normal levels of dopamine, could a person become addicted to that naturally high feeling? It turns out that you can. In fact, illegal drugs such as speed often flood the brain with dopamine and serotonin, and that is why they are so addictive. People get hooked on dopamine.
Okay, so dopamine can be addictive. So what? The next thing we looked at was what possible side effects too much or too little dopamine can have on a person. When a person lights up, nicotine causes the brain to release a flood of dopamine, which ratchets up a person’s feel-good feelings, but the flood eventually subsides, and when it does, the person experiences a craving for another cigarette. Depending on the person and how their brain works, it may take a few minutes or a few hours for the dopamine flood to subside. Chantix, on the other hand, provides the user with a steady supply of extra dopamine. When the brain is exposed to too much dopamine for extended periods of time, the side effects are paranoia, delusion, and even suicidal thoughts. This explains why persons addicted to speed eventually become paranoid and delusional and think everything is out to get them. On the other end of the spectrum, too little dopamine can cause a person to feel low on energy, feel as though daily tasks are insurmountable, and can lead to depression.
Under this theory, the patches and gums didn’t work because my husband’s dopamine levels dropped too low too quickly, causing irritability and depression. The Chantix didn’t work because it kept his brain saturated with too much dopamine, causing him to feel paranoid, delusional and suicidal. This was very interesting, because all this time we had blamed nicotine for his smoking addiction. We now believe that nicotine is not the addictive substance in cigarettes. We believe that people become addicted to the surge of dopamine that nicotine causes. Nicotine is not addictive in and of itself, but it causes an addiction to dopamine. If our theory is indeed true, then it could turn the scientific world on its head. More scientific research is required, but everything we discovered about dopamine levels and its effects on the brain make sense with what we’ve experienced while trying to quit smoking.
