Audience: Neuropsychiatric healthcare professionals, patients

FDA notified healthcare professionals and patients that it has required the manufacturers of the smoking cessation aids varenicline (Chantix) and bupropion (Zyban and generics) to add new Boxed Warnings and develop patient Medication Guides highlighting the risk of serious neuropsychiatric symptoms in patients using these products.

These symptoms include changes in behavior, hostility, agitation, depressed mood, suicidal thoughts and behavior, and attempted suicide. The added warnings are based on the continued review of postmarketing adverse event reports for varenicline and bupropion received by the FDA.

These reports included those with a temporal relationship between the use of varenicline or bupropion and suicidal events and the occurrence of suicidal ideation and suicidal behavior in patients with no history of psychiatric disease.

Healthcare professionals should advise patients to stop taking varenicline or bupropion and contact a healthcare provider immediately if they experience agitation, depressed mood, and any changes in behavior that are not typical of nicotine withdrawal, or if they experience suicidal thoughts or behavior.

這個藥還真是多災多難呀

之前的新聞也有提過:http://mulicia.pixnet.net/blog/post/12819682

撇開這些不講,貼一些漂亮的圖案給大家瞧瞧

或是你比較喜歡看NEJM版的:

champix 

說明:

Figure 1. The Actions of Nicotine and Varenicline in the Brain.

The principal site of nicotine action in the brain is the mesolimbic system (Panel A). Nicotine stimulates dopaminergic neurons located in the ventral tegmental area, increasing dopamine release in the nucleus accumbens. Nicotine interacts with nicotinic acetylcholine receptors, which are pentameric ion channels located in the mesolimbic system and elsewhere (Panel B). The highest-affinity nicotinic acetylcholine receptors consist of two α4 subunits and three β2 subunits. Nicotine binds to and causes a conformational change in the α4β2 nicotinic acetylcholine receptor, increasing sodium (Na+) influx. Varenicline is a partial agonist of the α4β2 nicotinic acetylcholine receptor that causes partial stimulation while it competitively inhibits nicotine binding.

 

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