The reinforcing effects of nicotine and stimulant medication in the everyday lives of adult smokers with ADHD: A preliminary examination

Abstract

Whereas the smoking prevalence rates in the general population are declining, rates among people diagnosed with attention-deficit/hyperactivity disorder (ADHD) continue to be elevated. Previous research has shown that nicotine may improve attention and mood, suggesting that nicotine may help ameliorate the attentional and emotional problems associated with ADHD. The present study examined the effects of nicotine with and without stimulant medication on ADHD symptoms, moods, and arousal in the everyday lives of smokers with ADHD. A total of 10 smokers with ADHD who were being treated with stimulant medication were asked to abstain from smoking while participating in the study. Participants underwent four conditions in randomized order: (a) Nicotine patch+stimulant medication, (b) nicotine patch only, (c) placebo patch+stimulant medication, and (d) placebo patch only. Each condition continued for 2 days, during which self-reports of ADHD symptoms and moods were obtained using electronic diaries. Lightweight ambulatory monitors recorded cardiovascular activity at each diary entry. Smoking abstinence was verified by expired carbon monoxide and salivary cotinine analysis. Results showed that nicotine patches and stimulant medication alone and in combination reduced difficulty concentrating and core ADHD symptoms compared with placebo patch only. Borderline improvement in impatience and self-control was seen with nicotine patch administration primarily on day 1. Nicotine patches also tended to elevate systolic and diastolic blood pressure compared with placebo patch during day 2. The findings suggest that smokers with ADHD experience nicotine-related reductions in ADHD symptoms during their everyday lives.

Smoking, nicotine and neuropsychiatric disorders

“…According to this assumption, NIC and in some studies selective a 4 b 2 nAChR agonists (ABT-418 and ABT-089) have beneficial impacts on behavioral symptoms of ADHD and/or ADHD-related cognitive disturbances (measured by behavioral inhibition, delay aversion and sustained attention tasks) (Gehricke et al, 2006;Newhouse, 2004, 2008;Poltavski and Petros, 2006;Wilens et al, 2005a,b;Wilens and Decker, 2007;Potter et al, 2006). Studies investigating the effect of AChE inhibitors (donepezil or galantamine) on symptoms of ADHD have yielded inconsistent results (Wilens et al, 2005a;Doyle et al, 2006;Yoo et al, 2007;Biederman et al, 2006a).…”

Attention-Deficit/Hyperactivity Disorder and Nicotine Dependence in Adults

“…Nicotine patch administration to a sample of nonsmoking adolescents clinically diagnosed with ADHD has been shown to improve cognitive/behavioral inhibition with an effect comparable to methylphenidate (21). Gehricke et al (22) found out that nicotine alone (administered by patch), in combination with stimulant medication, decreased inattention symptoms while increasing impulse control in a sample of clinically diagnosed adults with ADHD (23). Therefore, the hypothesis that smoking represents a form of self-medication against the ADHD symptomatology among adult smokers has significant validity (24).…”

Smoking to self-medicate attentional and emotional dysfunctions

“…The notion that individuals with specific deficits smoke for purposes of selfmedication (Khantzian, 1997; C. S. Pomerleau, Marks, & Pomerleau, 2000) is supported by evidence that nicotine treatment can attenuate dysfunction in depression (Haro & Drucker-Colin, 2004a, 2004b and attention-deficit/hyperactivity disorder (ADHD; Levin, Conners, Silva, Canu, & March, 2001). Individuals with deficits in attention may be self-medicating with nicotine to improve their attention (Bekker, Bocker, Van Hunsel, van den Berg, & Kenemans, 2005;Gehricke, Whalen, Jamner, Wigal, & Steinhoff, 2006). In contrast, individuals with affective dysfunctions may be self-medicating to regulate their emotions (Haro & Drucker-Colin, 2004b).…”