New antismoking drug Chantix: a true psychotomimetic?

New York Magazine has a fascinating first-person account of one man's experience with Chantix, the new anti-smoking medication which is currently generating reports of bizarre side effects like creepy dreams and suicidal or homicidal thoughts.

The author describes a series of experiences that are eerily reminiscent of accounts of schizophrenia. There is paranoia and difficulty determining what is real: "I tried to shake a weird, paranoid sense that I’d just been psychically raped by a household appliance," the author writes.

There are delusions of reference, the idea that particular experiences are being aimed specifically at you: "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?"

Over 90% of people with schizophrenia smoke in what is believed to be an attempt to self-medicate: some research finds that nicotine has antipsychotic and antidepressant actions.

Since Chantix works by partially blocking and partially activating a particular nicotine receptor, it might be expected to have a mixture of both positive and negative effects on psychosis and depression. Consequently, I expected to see lots of research looking at it in relation to schizophrenia.

In fact, I found only one paper-- which found that Chantix can indeed exacerbate symptoms of schizophrenia.

For decades, researchers have been looking at various drug states as models of this disorder. First it was LSD (which was labeled a "psychotomimetic" as a result), then amphetamine psychosis became the preferred model as the pharmacology began to be better understood.

This drug, however, sounds like it might be the real deal, at least in some users. Which is scary for people trying to quit smoking-- but might be very useful for researchers trying to understand psychotic disorders. If anyone is studying this, I'd love to hear more!!