January 1, 2011

This is a continuation of our last post. We were discussing the results of a study that measured the likelihood of certain drugs to be linked with violent or aggressive behavior toward another. The researchers assigned a rating to each and dubbed the list of particularly dangerous prescription drugs their “primary suspects.”

The anti-smoking drug Chantix, generic name varenicline, was ranked, hands down, the most dangerous drug of the 31 the researchers identified. With a rating of 18, the drug is 16.1 times more likely than basic nicotine replacement (rated 1.9) to link to aggressive or violent behavior. Bupropion — marketed as Zyban or Wellbutrin, for example — was the second most likely anti-smoking drug to be linked with such behavior; it rated 3.9, well below the Chantix rating.

Chantix affects the “pleasure” receptors that make that cigarette so satisfying. The effect is to reduce the craving for smoking, and the quit rates associated with Chantix are better than other drugs. The dangers are exponentially greater, though, and that prompted the FDA to give the drug a “black box” warning, indicating the drug’s side effects can be serious or even life-threatening.

Chantix outranked all other drugs, not just the drugs in the anti-smoking category. The next highest rating was for Prozac (fluoxetine), at 10.9. Prozac is one of the first and one of the best known SSRI antidepressants on the market. Two other SSRIs ranked among the primary suspects: Paxil (paroxetine) had a 10.3 rating, and Luvox (fluvoxamine) was rated 8.4. Other known risks associated with Paxil include severe withdrawal symptoms and a greater risk of birth defects than other SSRIs.

Antidepressants on the list fall into the SSRI and non-SSRI categories. The two most dangerous non-SSRI antidepressants were Pristiq (desvenlaxfaxine) and Effexor (venlafaxine). They were rated, respectively, at 7.9 and 8.3 times more likely to be linked to violent or aggressive behavior than other drugs.

ADHD drugs also ranked high. Amphetamines of any kind were rated 9.6. Strattera (atomoxetine) was rated 9. The sedative most likely to be linked to violence or aggression was Halcion (triazolam), which rated 8.7.

The Time magazine article about the study lists another drug, Lariam (mefoquine), on the top 10 list. The drug was not included by the researchers as a primary suspect, perhaps because it is prescribed less frequently in the U.S. The malaria drug has been linked to bizarre behavior in patients for many years.

Source: Time, “Top 10 legal drugs linked to violence,” 01/07/11

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