Putative (unpleasant) psychedelic effects of anti-smoking drug Varenicline
http://en.wikipedia.org/wiki/Varenicline
“Varenicline is a partial agonist of the ?4?2 subtype of the nicotinic acetylcholine receptor.” — this is apparently the subtype that nicotine acts on in the CNS. Varenicline is also a partial or full agonist of some other nicotinic receptor subtypes.
The following article describes various disturbing psychedelic effects of long-term varenicline use. Excerpts after the break:
http://nymag.com/news/features/43892/
Note: from anecdotal evidence in other parts of the article, it seems like these sorts of effects don’t happen to everyone on the drug, in fact it sounds like they are uncommon.
”
The next night, I nodded off listening to Radiohead’s In Rainbows, feeling a little guilty that I’d paid zero dollars for it. I had a quick blip of a dream: A dark, inky fluid was jolting violently from the corners of my ceiling, zigzagging its way across the walls and wooden floor in jerky sync to the music.
It was only a dream, though it seemed more immediate and visceral than my usual fare, which I rarely remember after waking up. The following night, things got even stranger. I fell asleep with Bravo blaring on my TV and dreamed that a red-faced Tim Gunn was pushing me against the wall. “But I always thought you were so nice,” I said.
By night four, my dreams began to take on characteristics of a David Cronenberg movie. Every time I’d drift off, I’d dream that an invisible, malevolent entity was emanating from my air conditioner, which seemed to be rattling even more than usual. I’d nap for twenty minutes or so before bolting awake with an involuntary gasp. I had the uneasy sense that I wasn’t alone.
I smoked a cigarette, then tried going back to sleep. But each time I started napping, I’d dream that something increasingly ominous—carbon monoxide? Vampires?—was sucking vital essence out of me. Soon the clock on my desk read 3:20 a.m.
The most unsettling thing about sleeping on Chantix is that I never felt like I was truly asleep. Some part of me remained on guard. It was more like lucid dreaming, what I thought it might feel like to be hypnotized. And it didn’t entirely go away come morning. As I showered, shaved, and scrambled into clothes, I tried to shake a weird, paranoid sense that I’d just been psychically raped by a household appliance.
….
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.
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.
After a few weeks on Chantix, I had managed to stop smoking altogether—but it didn’t feel like a triumphant turn of events. I’d become rather reclusive, avoiding calls from friends, and basically just shuttling back and forth between my office and my apartment. I began to dread six o’clock; it meant I had to walk through the streets again. The subway was now out of the question; it made me too nervous. I stopped going to the gym, too.
I wondered whether Chantix was zapping my brain’s pleasure-delivery system to such a degree that not only did I find no reward in cigarettes, but I also found no reward in socializing, exercising, writing, or any of my usual self-stimulating tricks. I’d pace the floor, sit on the bed, channel surf, pace some more, try to read, but the room had a stale, sinking feeling. Maybe I should go and grab a drink—then at least I might be able to get some rest.
There was no warning against drinking while on Chantix, and even if there had been, I can’t say with any honesty that I’d have adhered to it. (I wasn’t taking any other medication, though.) But while I’ve had my fair share of dark and drunken nights over the years, what I experienced on Chantix was something else altogether. One evening, I steeled myself to go on a date, but after a few drinks with the guy, I abruptly burst into tears mid-sentence. The crying jag lasted about 30 minutes, with the thought I can’t do this anymore looping through my head. This was happening a lot lately, as though someone had spliced other people’s thoughts into the tape whirl of my brain.
Another night, at an East Village bar, an older man in a trench coat caught my attention. I chatted him up for a while, until I realized I was actually trying to go home with the shadow cast by a potted plant. With alcohol in my system, I was somehow able to take this hallucination in stride: “The man who got away?…?” But that same evening ended with my taunting a skinhead who was improbably on the corner of Avenue A and 14th Street. “You must be lost,” I snapped. “Are you looking for 1993?” He ended up chasing me into a deli and saying he was going to murder me. (The guy at the register called the cops and the skinhead fled, so I’m fairly confident that he, at least, was real.)
I’ve blacked out a handful of times before, but now it wasn’t unusual to have five or six hours completely wiped out of my memory. 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. One morning, I found an unopened container of dental floss in my coat, as well as a batch of business cards from people whom I couldn’t remember at all. Later that day I received a text message: “I had a great time meeting you … I could have talked to you for another two hours. 
” I have no idea who that person was.
Why didn’t I just stop taking the drug? I did consider it. But there’s something particularly dispiriting about quitting a medicine that’s supposed to be helping you quit smoking. I kept thinking that my body was still getting used to being on Chantix and off cigarettes, that I should wait until everything readjusted itself.
A few nights later, a friend invited me to a party and I reluctantly agreed. I was still avoiding my closest friends for fear that they’d notice changes in my behavior. But maybe I’d feel better if I stopped keeping to myself, for just a night. At the party, I tried to impersonate myself as best I could, but I found myself staring and nodding blankly, actually having difficulty understanding what people were trying to say, and getting oddly touchy at offhand comments.
I was offered a piece of cake on a plate and a fork. For the life of me, I couldn’t figure out the puzzle. How the hell were these pieces supposed to fit together? Fork. Plate. Cake. What sort of maniac would present me with something like this at a party? I abandoned the cake for a vodka tonic, which I drank in silent rage.
I left without saying good-bye. In the cab, I watched the city slash past the windows and was tempted to just throw open the door. Running up the stairs to my apartment, I barely had the door open before the crying started again. I sat on the edge of the bed, doubled over, and I felt severely ill, as though some freakish primal despair had finally been loosened from my stomach. The sensation was more like vomiting than any sadness I’ve ever experienced, and the shrieking sobs were punctuated by sudden jags of rage. Like a spoiled teenager, I’d suddenly uproot drawers from the bureau, push all the belongings off shelves with a sudden swat of the arm, smash a glass against the wall, and then the crying would take over yet again. Meanwhile, the room seemed to be pulsing and reverberating around me, and my eye would keep zeroing in on objects—the television, the AC, a pair of shoes—and feel as though they were somehow buzzing with life and gleefully watching me endure the biggest meltdown I’d ever had. I had somehow ruined myself, and suicide seemed like a good way to avoid the embarrassment of this fact’s being exposed.
The next morning, I called in sick to work and started cleaning up the considerable mess I’d made. I had to throw out a bunch of broken CDs, smashed glasses, torn clothes, ripped photographs, and the remaining boxes of Chantix from my medicine cabinet.
”