Chantix vs Wellbutrin

Introduction

About Chantix and Wellbutrin

Smoking is highly addictive because nicotine highjacks the reward pathway in the brain. When we smoke, the nicotine we inhale attaches itself to presynaptic ally on neuron receptors made for accepting acetylcholine, stimulating dopamine production. The repetitive production of dopamine makes the body depend on nicotine and crave smoking.

Quitting smoking is strenuous, and most people relapse. Chantix and Wellbutrin are both FDA-approved medications to aid smoking cessation, which do not contain nicotine and are still as effective as nicotine replacement therapy. Chantix is a partial agonist with relation to the nicotinic acetylcholine receptors that nicotine binds to, while Wellbutrin is a mild antagonist and a norepinephrine and dopamine reuptake inhibitor (NDRI).

What is Chantix?

Chantix is the world's first partial nicotinic acetylcholine receptor agonist and has clinically proven to be the most effective monotherapy to aid smoking cessation. It has highly promising efficacy rates, especially in the first four weeks. The FDA approved Chantix in ²⁰⁰⁶. It is relatively new, and its long-term effects are still unknown. However, it is a highly promising drug in its class.

What conditions is Chantix approved to treat?

The FDA approves Chantix for use as a treatment to aid smoking cessation. It can be used on its own or in combination with another therapy, such as nicotine replacement therapy.

How does Chantix work for Smoking Cessation?

Chantix is a partial nicotinic acetylcholinergic receptor agonist. Just as nicotine binds itself to nicotinic acetylcholinergic receptors, so does Chantix. Once bound at the receptor, nicotine and Chantix cause membrane polarization, creating a nerve impulse. These impulses signal the brain to produce a neurotransmitter known as dopamine. The consistent and repetitive release of dopamine in the brain makes nicotine addictive.

Chantix as a partial agonist produces much less dopamine than nicotine. That means it doesn’t make you feel as good as after smoking and doesn’t make the withdrawal symptoms completely disappear. However, it is enough for a person who has decided to quit smoking and needs a little help.

What is Wellbutrin?

Wellbutrin is an atypical antidepressant and drug to aid smoking cessation. It is an NDRI, a norepinephrine and dopamine reuptake inhibitor, and a mild nicotinic acetylcholinergic receptor antagonist.

That means it prevents neurotransmitters like norepinephrine and dopamine from reabsorbing into the bloodstream, essentially “trapping” them in the brain for longer. This produces the effect of increased dopamine production.

Bupropion, the generic name for Wellbutrin, was approved by the FDA in ¹⁹⁸⁶.

What conditions is Wellbutrin approved to treat?

FDA approves Wellbutrin to treat Smoking Cessation along with Depression.

How does Wellbutrin work for Smoking Cessation?

Wellbutrin interferes with different neurotransmitters to help reduce cigarette cravings and nicotine withdrawal.

Unlike Chantix, which stimulates the neuron to send a message to the brain, producing dopamine, Wellbutrin prevents the reabsorption of dopamine, keeping it in the brain for longer. This makes the body feel like dopamine is in higher production and the nicotine reward pathway is still in action, relieving withdrawal symptoms.

Effectiveness

How effective are Chantix and Wellbutrin for treating Smoking Cessation?

Chantix and Wellbutrin are highly effective for treating nicotine withdrawal to aid smoking cessation. Chantix is more effective initially, with a 44.0% efficacy rate in the first four weeks of treatment, against placebos with 17.7%, while Wellbutrin only has a rate of 29.5%.

However, in the long term, both have the same effectiveness. Chantix is known to be more effective than nicotine replacement therapy (NRT) at standard dosages while equal to NRT at high dosages. At the same time, Wellbutrin has been established as equal to NRT at standard dosages. The Combined treatment of NRT and Chantix has been known to be the most effective for success in smoking cessation.

Side Effects

What are the most common side effects of Chantix?

Common side effects of Chantix include

nausea (may persist for several months),
stomach pain,
indigestion,
constipation,
gas,
vomiting,
headaches,
weakness,
tiredness,
unusual dreams,
sleep problems (insomnia),
headache, dry mouth, or
unpleasant taste in your mouth.

Are there any potentially serious side effects of Chantix?

* If you experience any of these serious side effects, seek medical help immediately

Potentially dangerous side effects of Chantix include

burning feeling in feet/toes,
unusual pain in the legs when walking,
seizure (convulsions),
thoughts about suicide or hurting yourself,
restlessness,
strange dreams,
sleepwalking,
trouble sleeping,
mood or behavior changes
depression,
agitation,
hostility,
aggression,
chest pain or pressure,
pain spreading to the jaw or shoulder,
nausea,
sweating,
sudden numbness or weakness,
slurred speech, and
problems with vision or balance

What are the most common side effects of Wellbutrin?

The most common side effects of Wellbutrin include the following:

agitation
dry mouth
insomnia
headache
nausea
vomiting
constipation
stomach pain
dizziness
ringing in the ears
vision problems or blurred vision
loss of interest in sex
sore throat
muscle pain
itching or skin rash
increased sweating
increased urination
tremor
changes in appetite
weight loss or gain
joint aches
strange taste in the mouth
diarrhea
seizures (especially at higher doses).

Are there any potentially serious side effects of Wellbutrin?

* If you experience any of these serious side effects, seek medical help immediately

Potentially serious side effects of Wellbutrin are:

seizure (convulsions)
confusion
unusual changes in mood or behavior,
blurred vision
tunnel vision
eye pain or swelling
seeing halos around lights
fast or irregular heartbeat
racing thoughts
increased energy
reckless behavior
feeling extremely happy or irritable
talking more than usual
severe problems with sleep
severe headache
confusion
slurred speech
arm or leg weakness
trouble walking
loss of coordination
feeling unsteady
very stiff muscles
high fever
profuse sweating or tremors

Contraindications and interactions

Warnings and general precautions for Chantix and Wellbutrin

Both Chantix and Wellbutrin have not been FDA-approved for use in patients under 18 years of age. There is no evidence that the use of Chantix or Wellbutrin may cause any birth defects or harm to the mother, but pregnant and breastfeeding mothers are told to avoid using Chantix and Wellbutrin due to the lack of clinical data proving its safety.

Contraindications and important interactions for Chantix and Wellbutrin

Contraindications

Chantix

Previously noticed hypersensitive skin reaction to ingesting Chantix

Wellbutrin

Individuals with Bulimia Nervosa should not take Wellbutrin

Individuals with Anorexia Nervosa should not take Wellbutrin.

Individuals with Hypertensive disease should not take Wellbutrin

Drug/Medication Interactions

Chantix

No known drug interactions

Wellbutrin

Do not take Wellbutrin if you’re taking Benzodiazepines

Do not take Wellbutrin if you have abruptly ceased taking antiepileptic drugs

Aripiprazole (Abilify)

Amphetamine/methamphetamine (Adderall)

Duloxetine (Cymbalta)

Escitalopram (Lexapro)

Quetiapine (Seroquel)

Tramadol

Trazodone

Sertraline (Zoloft)

Fluoxetine (Prozac)

Food/Beverage/Supplement Interactions

Chantix

There are no known food/beverage or supplement interactions with Chantix

Wellbutrin

Wellbutrin should not be combined with caffeinated drinks

Wellbutrin should generally not be combined with alcohol, as it may increase your risk for seizures. If you are prone to drinking alcohol, speak about this interaction with your doctor

Cost Comparison

How much do Chantix and Wellbutrin cost?

A single 1mg tablet for Chantix is $2.61, totaling $156.6 for 60 pills. Starting and continuation packs are available for $148.5.

Wellbutrin is expensive, but the generic version of Wellbutrin, bupropion, is much more affordable. 60 tablets of Wellbutrin SR (100 mg) averages around $500, which works out to $16–32/day, depending on your dose.

The generic version of Wellbutrin, Bupropion (100 mg tablets), is available in packs of 30 capsules and above, with approximate costs of $0.25 to $0.80 per day for dosages of 100 mg/day, or between $0.50 and $1.50 per day if you are taking more typical dosages of 200 to 300 (or even 450) mg/day.

The name-brand version of Wellbutrin is expensive. However, the generic name version is affordable. Chantix is the more affordable name-brand option. However, keep in mind that price is not the most important thing to consider when choosing the right drug.

Popularity of Chantix and Wellbutrin

Both Chantix and Wellbutrin are effective for treatment aiding smoking cessation. While Chantix is proven more effective in the short term, the difference evens out to be negligible in the long term. Wellbutrin is more popular as it has been around more. Due to its price point and promising trials, Chantix is growing in popularity but is prescribed less as compared to Wellbutrin

Conclusion

Takeaway

Chantix and Wellbutrin both ease the symptoms of nicotine withdrawal by interacting with the nicotine reward pathway and increasing dopamine production. Nicotine stimulates the production of dopamine by binding itself to the nicotinic acetylcholine receptors present on neurons and stimulating their membranes, carrying a nerve impulse.

Chantix is partially agonistic to the same nicotinic acetylcholine receptors. That means it attaches itself in the same place as nicotine does and stimulates signals to the brain to produce dopamine, however, in a much lesser amount. Wellbutrin also attaches to the same receptor; however, as an antagonist, it does not stimulate a nerve signal causing dopamine production. It maintains dopamine in the brain by inhibiting its reuptake along with another neurotransmitter, norepinephrine.

Both work in different ways to maintain dopamine in the brain to reduce smoking cravings in patients. Chantix is proven more effective in the first four months and the more affordable of the two; therefore, it is widely considered the better option. However, some people are better suited to treatment with Wellbutrin due to it being a norepinephrine dopamine reuptake inhibitor (NDRI). In the end, it’s up to the physician to decide which treatment to recommend after providing all the options to the patient.