It wasn’t until after I’d stopped taking Chantix (and switched to the patch) that I would read about other cases, ones in which violence was directed inward rather than out. In December, Omer Jama, a TV news editor in the U.K., slashed his wrists and died, a few weeks after going on Champix. (In the U.K., Chantix is known as Champix, but the FDA objected to that name because it was “overly fanciful and overstates the efficacy of the product.”) Shortly thereafter, a 36-year-old welder hanged himself after completing a thirteen-week Champix regimen.
The term suicidal ideation looks pretty dead on the page, and if you were ever to experience such a symptom, it’s unlikely you’d pick up on it right away: “Here comes that damned suicidal ideation again. I had better call my physician.” For me, self-destructive fantasies slowly began cropping up as cartoonish flights of fantasy—nagging, almost imperceptible chatter that became a little more concrete and domineering with every passing day.
A week into my Chantix usage, I started to feel as if the city landscape had imperceptibly shifted around me. Mundane details began to strike me as having deep, hidden significance. The neon arch above McDonald’s: The lights blinked on and off in some sort of pattern, and I needed to crack the code. One of my co-workers was messing with some papers: What is he trying to imply with all that damned crinkling? Sitting in the subway: A man hurries to get inside. His hand, holding a cup of coffee, gets stuck in the closing door. I watch the hand wriggle. The lid bursts open and steaming brown liquid hits the floor. Fingers twitch and splay. Coffee splashes in crisscrossing slats through the subway car. It was a sign—something bad was going to happen.
It felt as if the essential barrier between reality and my imagination had eroded. Was it because I wasn’t getting enough R.E.M. sleep, so my dream life was rebelling, pouring into daylight, insisting to be attended to, one way or another?
Meanwhile, smoking cigarettes had become an exercise in futility. At work, I’d put on my coat, head out, and light up—but there was no pleasure to be found, just a truly nasty taste.
One afternoon, I was typing away at advertising copy, and as I did so, I began to wonder how I had succeeded in fooling myself that my life had any sort of value at all. Writing? Sure, it was what I’d wanted to do since I was 6—but at the end of the day, who cared? Maybe I should just go downstairs and leap in front of a tour bus. Or launch my head through the computer screen. All this seemed logical, but also weirdly funny, even at the time: I could see how crazy these impulses were, I could recognize them as suicidal clichés. But I couldn’t make them go away.
I’d wake up with my clothes on, music blasting, and strange half-eaten sandwiches lying on the floor that I had no recollection of buying.
A few minutes later, they did, and I thought, Who was the depressed seventh-grade goth girl who had just muscled into my brain? I hadn’t thought of suicide in any serious way since I was a teenager, and that had just been adolescent posturing. I had no interest in killing myself—that’s why I wanted to quit smoking in the first place.
Seidman, who has seen only a handful of patients on Chantix, says that “one guy said he was having waking nightmares—actually experiencing nightmares while he was awake.” Last week, Dr. Mary O’Sullivan, the director of the Smoking Cessation Program at St. Luke’s–Roosevelt (who, like Seidman, says she has no ties with Pfizer), saw her first Chantix patient with “suicidal ideation.” This “was quite a shock,” she says. “He had no background in mental illness, no underlying tendency to depression.” However, before then she had “given it to well over 200 patients without a single side effect.” And she still believes that in terms of smoking cessation, “it’s been a miracle drug.”
“I haven’t seen suicide in patients, and I haven’t seen psychotic breaks, either,” says Dr. Elliot Wineburg (also no Pfizer affiliation) of the Mount Sinai School of Medicine. “But as far as people successfully quitting smoking, I also haven’t seen great results.”
My own, spectacularly unscientific survey of people on the drug was equally mixed. “It’s getting easier by the day,” says Nicholas Bullock, a 27-year-old art director. “And the nausea has stopped as well.” Others said Chantix worked but left them feeling temporarily lobotomized. Chris Masters, a 26-year-old investment-firm manager, began experiencing “daytime hallucinations. In the car, I’d feel my cell phone vibrate and roll the window down.” On the way to a wedding in the country, “I decided I would plow into a herd of sheep if the street I was looking for didn’t come up soon.” And then there’s Elizabeth McCullough, a 48-year-old musician. “Chantix made me desperately suicidal, just crazy,” she says. “I joked to my friends that Chantix was the ultimate quit-smoking drug, because when you kill yourself, there’s no chance of relapse.”