Anti-smoking drug linked to suicide — (BBC News)

SSRI Ed note: 18-yr-old takes Wellbutrin to quit smoking, dies by suicide.

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BBC News

Feb 24, 2003

A teenage student desperately trying to give up cigarettes by taking the anti-smoking drug Zyban killed himself after it made him depressed, an inquest has heard.

Nick Hirst, of Prestbury, Cheshire, changed from being an “outgoing and happy” student after taking the drug to kick his habit, the coroner’s court in Macclesfield was told.

Recording a verdict of suicide, Cheshire coroner Nicholas Rheinberg said the use of Zyban may have been one of the factors in the death of the 18-year-old.

Mr Hirst, a first-year student at Nottingham Trent University, wanted to give up smoking to improve his fitness for rugby.

 I thought it was likely [Nick] had a mixed anxiety depressive disorder, possibly precipitated by Zyban,” Dr Howard Waring, consultant psychiatrist

The inquest was told that after being prescribed Zyban, made by pharmaceutical giant GlaxoSmithKline, by a doctor, Mr Hirst told close family and friends that he felt an immediate “change within himself” and suffered bouts of depression.

He took the drug for a week and then stopped.

Six months later, in May 2001 he was found hanging from a tree in Riverside Park in Macclesfield after earlier telling his brother Jonathan “I don’t want to be here”, the court was told.

Mr Rheinberg said one reason the student committed suicide could have been the effects of Zyban, but there were other reasons which could have contributed to his death.

Those included an obsessive personality and heavy drinking.

‘Happy, outgoing’

In an outburst in the inquest, Mr Hirst’s mother Dianne said: “I just feel that Zyban stopped him smoking. He didn’t want to smoke, he didn’t want to drink. He didn’t want anything to do with his car or his dog.”

She claimed Zyban not only stopped him smoking, but stopped him wanting to do anything.

“He loved his rugby,” she earlier told the inquest while giving evidence.

“He was a very happy and outgoing young man who didn’t have enough hours in the day to do everything he wanted to do.”

Public awareness

Dr Howard Waring, a consultant psychiatrist who treated Mr Hirst, told the hearing: “I thought it was likely he had a mixed anxiety depressive disorder, possibly precipitated by Zyban and that he should have anti-depressants.

“But Nick said that the effects of Zyban on him had been so radical that he wouldn’t be willing to take any medication of an anti-depressant type.”

Dr Robin Ferner, a consultant physician and an expert on the effects of drugs, told the hearing it was impossible Zyban was still in Mr Hirst’s system at the time of his death.

“But on balance it’s one of the contributors to the alteration in mind that he suffered in November,” he added.

In a statement released after the verdict, Mr Hirst’s family said: “We hope this inquest will raise public awareness about the potential dangers of Zyban.”

10.5m users

GlaxoSmithKline offered its condolences to Mr Hirst’s family.

But a spokeswoman added the company was “fully confident of the contribution Zyban makes in helping smokers to successfully stop smoking”.

She said the drug had been used by an estimated 10.5m people worldwide after thorough tests for safety.

“We take all reports of suspected adverse events regarding any of its medicines very seriously,” she said.

“The safety of all medicines is continually monitored by both GlaxoSmithKline and the Medicines Control Agency.

“When people try to stop smoking, mood changes including depression, agitation, anxiety and difficulty concentrating are commonly seen – irrespective of whether nicotine replacement therapy, Zyban or willpower alone is used.

“Clearly is it not appropriate for the coroner to review all the available evidence for Zyban and as such he has had to base his judgement on the information available for this one case.”