Nicotine effects on adults with attention-deficit/hyperactivity disorder

Abstract

Several lines of evidence suggest that nicotine may be useful in treating the symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD). The current study was an acute, placebo-controlled double-blind experiment to determine whether nicotine might be useful as an alternative treatment of adults with ADHD symptomatology. Six smokers and 11 nonsmokers who were outpatient referrals for ADHD were diagnosed by DSM-IV criteria. Measures of treatment effect included the Clinical Global Impressions (CGI) scale, Hopkins' symptom check list (SCL-90-R), the Profile of Mood States (POMS), Conners' computerized Continuous Performance Test (CPT), the Stroop test, and an interval-timing task. The smokers underwent overnight deprivation from smoking and were given a 21 mg/day nicotine skin patch for 4.5 h during a morning session. The nonsmokers were given a 7 mg/day nicotine skin patch for 4.5 h during a morning session. Active and placebo patches were given in a counter-balanced order approximately 1 week apart. Nicotine caused a significant overall nicotine-induced improvement on the CGI. This effect was significant when only the nonsmokers were considered, which indicated that it was not due merely to withdrawal relief. Nicotine caused significantly increased vigor as measured by the POMS test. Nicotine caused an overall significant reduction in reaction time (RT) on the CPT, as well as, with the smokers, a significant reduction in another index of inattention, variability in reaction time over trial blocks. Nicotine improved accuracy of time estimation and lowered variability of time-estimation response curves. Because improvements occurred among nonsmokers, the nicotine effect appears not to be merely a relief of withdrawal symptoms. It is concluded that nicotine deserves further clinical trials with ADHD.

Neuropsychological function in patients with a single gene mutation associated with autosomal dominant nocturnal frontal lobe epilepsy

“…Administration of nicotine to abstinent smokers improves general alertness, attention, and vigilance [4,5]. Nicotine improves performance on vigilance tasks [6,7], inhibition of prepotent responses [8], and verbal learning [9] in nonsmokers. Effects such as these, however, are thought to reflect an influence on general alertness, rather than the primary influence of specific cognitive domains [10,11].…”

The Effects of Transdermal Nicotine on Cognition in Nonsmokers with Schizophrenia and Nonpsychiatric Controls

“…In summary, current evidence suggests that nicotinic agonists may have a therapeutic use for the treatment of cognitive dysfunction in schizophrenia and possibly other neuropsychiatric disorders (Levin et al, 1996a;White and Levin, 1999;Kelton et al, 2000). However, many studies investigating the effects of nicotinic stimulation in schizophrenia have been conducted in smokers who have undergone a brief period of abstinence from smoking prior to testing of nicotine effects.…”

Chronic nicotine administration improves attention while nicotine withdrawal induces performance deficits in the 5-choice serial reaction time task in rats

“…abstinence (Bates et al, 1995;Bell et al, 1999;Ernst et al, 2001;Foulds et al, 1996;Warburton and Mancuso, 1998) and in patients with different psychiatric and neurological disorders, such as Alzheimer's disease, attention deficit and hyperactivity disorder and schizophrenia (Levin et al, 1996;Sahakian et al, 1989;White and Levin, 2004). Thus, it has been argued that nicotine-induced cognitive enhancement in these populations reflects the reversal of cognitive deficits characteristic of both nicotine withdrawal and/or the neuropsychiatric disease states.…”