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Nicotine effects on adults with attention-deficit/hyperactivity disorder

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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 counterbalanced 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 clincal trials with ADHD.

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References

  • Ahtee L, Kaakkola S (1978) Effect of mecamylamine on the fate of dopamine in striatal and mesolimbic areas of rat brain: Interaction with morphine and haloperidol. Br J Pharmacol 62:213–218

    Google Scholar 

  • Barkley R (1990) Attention deficit hyperactivity disorder: a handbook for diagnosis and treatment Guidford, New York

  • Barkley RA (1995) Impaired delayed responding: a unified theory of attention deficit hyperactivity disorder. In: Routh DK (ed) Disruptive behavior disorders in childhood: essays Honoring Herbert C. Quay. Plenum, New york, pp 1–73

    Google Scholar 

  • Benowitz NL (1993) Nicotine replacement therapy: what has been accomplished—can we do better? Drugs 45:157–170

    Google Scholar 

  • Church R, Miller KD, Meck WH, Gibbon J (1991) Symmetrical and asymmetrical sources of variance in temporal generalization. Anim Learn Behav 19:207–214

    Google Scholar 

  • Clarke PBS, Hommer DW, Pert A, Skirboll LR (1985) Electrophysiological actions of nicotine on substantial nigra single units. Br J Pharmacol 85:827–835

    Google Scholar 

  • Clarke PBS, Pert A (1985) autoradiographic evidence for nicotine receptors on nigrostriatal and mesolimbic dopaminergic neurons. Brain Res 348:355–358

    Google Scholar 

  • Clarke PBS, Pert CB, Pert A (1984) Autoradiographic distribution of nicotine receptors in rat brain. Brain Res 323:390–395

    Google Scholar 

  • Cloninger CR, Przybeck TR, Svrakic DM (1991) The Tridimensional Personality Questionnaire: US normative data. Psychol Rep 69:1047–1057

    Google Scholar 

  • Conners CK (1994) The Continuous Performance Test (CPT): use as a diagnostic tool and measure of treatment outcome. Annal Convention of the American Psychological Association. Los Angeles, Calif.

  • Conners CK (1995) The Continuous Performance Test. Multi-Helath Systems, Toronto

    Google Scholar 

  • Conners CK, March JS, Fiore C, Butcher T (1994) Information processing deficits in ADHD: effect of stimulus rate and methylphenidate. Annual Meeting of the American College of Neuropsychopharmacology

  • Derogatis LR (1983) SCL-90-R; administration scoring and procedures manual-II Clinical Psychometric Research., Towson, md.

  • DSM-IV Task Force (1994) Diagnostic and statistical manual for mental disorders: DSM-IV. American Psychiatric Association, Washington, D.C.

    Google Scholar 

  • Fagerstrom KO, Schneider NG (1989) Measuring nicotine dependence; a review of the Fagerström tolerance questionnaire. J Behav Med 12:159–182

    Google Scholar 

  • Fagerström KO, Pomerleau O, Giordani B, Stelson F (1994) Nicotine may relieve symptoms of Parkinson's disease. Psychopharmacology 116:117–119

    Google Scholar 

  • Grenhoff J, Aston-Jones G, Svensson TH (1986) Nicotinic effects on the firing pattern of midbrain dopamine neurons. Acta Physiol Scand 128:151–158

    Google Scholar 

  • Haikala H, Ahtee L (1988) Antagonism of the nicotine-induced changes of the striatal dopamine metabolism in mice by mecamylamine and pempidine. Naunyn-Schmiedberg's Arch Pharmacol 338:169–173

    Google Scholar 

  • Hamilton M (1960) A rating scale for depression. J Neurol Neurosurg Psychiatry 23:56–62

    Google Scholar 

  • Hatsukami D, Fletcher L, Morgan S, Keenan R, Amble P (1989) The effects of varying cigarette deprivation duration on cognitive and performance tasks. J Subst Abuse 1:407–416

    Google Scholar 

  • Henningfield JE (1984) Behavioral pharmacology of cigarette smoking. Adv Behav Pharmacol 4:131–210

    Google Scholar 

  • Hughes JR (1989) Dependence potential and abuse liability of nicotine replacement therapies. Biomed Pharmacother 43:11–17

    Google Scholar 

  • Ikard FF, Green DE, Horn O (1969) A scale to differentiate between types of smoking as related to the management of affect. Int J Addict 4:649–659

    Google Scholar 

  • Imperato A, Mulas A, Di Chiara G (1986) Nicotine preferentially stimulates dopamine release in the limbic system of freely moving rats. Eur J Pharmacol 132:337–338

    Google Scholar 

  • Jarvik ME (1991) Beneficial effects of nicotine. Br J Addict 86:571–575

    Google Scholar 

  • Jones GMM, Sahakian BJ, Levy R, Warburton DM, Gray JA (1992) Effects of acute subcutaneous nicotine on attention, information processing and short-term memory in Alzheimer's disease. Psychopharmacology 108:485–494

    Google Scholar 

  • Levin ED (1992) Nicotinic systems and cognitive function. Psychopharmacology 108:417–431

    Google Scholar 

  • Levin ED, Rose JE (1995) Acute and chronic nicotinic interactions with dopamine systems and working memory performance. In: Lajtha A, Abood L (eds) Functional diversity of interacting receptors, New York Academy of Sciences, New York, pp 218–221

    Google Scholar 

  • Levin ED, Rosecrans J (1994) The promise of nicotinic-based therapeutic treatments. Drug Dev Res 31:1–2

    Google Scholar 

  • Levin ED, Karan L, Rosecrans J (1993) Nicotine: an addicitive drug with therapeutic potential. Med Chem Res 2:509–513

    Google Scholar 

  • McConville BJ, Fogelson MH, Norman AB, Klykylo WM, Manderschied PZ, Parker KW, Sanberg PR (1991) Nicotine potentiation of haloperidol in reducing tic frequency in Tourette's disorder. Am J Psychiatry 148:793–794

    Google Scholar 

  • McNair DM, Lorr M, Droppleman LF (1981) EdITs manual for the profile of mood states. Educational and Industrial Testing Service, San Diego

    Google Scholar 

  • Meck WH, Church RM (1987) Cholinergic modulation of the content of temporal memory. Behav Neurosci 101:207–214

    Google Scholar 

  • Meru G, Yoon KP, Boi V, Gessa GL, Naes L, Westfall TC (1987) Preferential stimulation of ventral tegmental area dopaminergic neurons by nicotine. Eur J Pharmacol 141:395–399

    Google Scholar 

  • Newhouse PA, Sunderland T, Tariot PN, Blumhardt CL, Weingartner H, Mellow A, Murphy DL (1988) Intravenous nicotine in Alzheimer's disease: a pilot study. Psychopharmacology 95:171–175

    Google Scholar 

  • NIMH (1985) CGI (Clinical Global Impression) scale. Psychopharmacol Bull 21:839–843

    Google Scholar 

  • Palmer KJ, Buckley MM, Faulds D (1992) Transdermal nicotine: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy as an aid to smoking cessation Drugs. 44:498–529

    Google Scholar 

  • Peeke SC, Peeke HVS (1984) Attention, memory, and cigarette smoking. Psychopharmacology 84:205–216

    Google Scholar 

  • Penney TB, Williams CL, Meck WH (1993) Developmental dyslexia and attentional processing in a temporal bisection task. 21st Annual Meeting of the International Society for Developmental Psychobiology. Alexandria, Va.

  • Pickworth WB, Bunker EB, Henningfield JE (1994) Transdermal nicotine: reduction of smoking with minimal abuse liability. Psychopharmacology 115:9–14

    Google Scholar 

  • Pomerleau CS, Downey KK, Stelson FW, Pomerleau OF (1995a) Smoking and adult ADHD: a connection? J Addict Dis (in press)

  • Pomerleau OF, Downey KK, Stelson FW, Pomerleau CS (1995b) Cigarette smoking in adult patients diagnosed with attention deficit hyperactivity disorder. J Subst Abuse(in press)

  • Pullan RD, Rhodes J, Ganesh S, Mani V, Morris JS, Williams GT, Newcombe RG, Russell MAH, Feyerabend C, Thomas GAO, Sawe U (1994) Transdermal nicotine for active ulcerative colitis. N Engl J Med 330:811–815

    Google Scholar 

  • Sahakian BJ, Jones GMM (1991) The effects of nicotine on attention, information processing, and working memory in patients with dementia of the Alzheimer type. In: Adlkofer F, Thruau K (eds) Effects of nicotine on biological systems. Birkhauser Verlag, Basel, pp 623–230

    Google Scholar 

  • Schwartz RD (1986) Autoradiographic distribution of high affinity muscarinic and nicotinic cholinergic receptors labeled with [3H] acetylcholine in rat brain. Life Sci 38:2111–2119

    Google Scholar 

  • Stroop JR (1935) Studies of interference in serial verbal reactions. J Exp Psychol 18:643–661

    Google Scholar 

  • Warburton DM, Arnall C (1994) Improvements in performance without nicotine withdrawal. Psychopharmacology 115:539–542

    Google Scholar 

  • Warburton DM, Rusted JM, Fowler J (1992) A comparison of the attentional and consolidation hypotheses for the facilitation of memory by nicotine. Psychopharmacology 108:443–447

    Google Scholar 

  • Wearden JH, McShane B (1988) Interval production as an analogue of the peak procedure: Evidence for similarity of human and animal timing process. Q J Exp Psychol 40B:363–375

    Google Scholar 

  • Wender P (1995) Attention-deficit hyperactivity disorder in adults. Oxford University Press, New York

    Google Scholar 

  • Wender PH, Wood DR, Reimherr FW (1991) Pharmacological treatment of attention deficit disorder, residual type (ADD-RT) in adults. In: Greenhill LL, Osman BB (ed) Ritalin: theory and patient management. Mary Ann Liebert, New York, pp 25–33

    Google Scholar 

  • Wesnes K, Warburton DM (1983) Smoking, nicotine and human performance. Pharmacol Ther. 21:189–208

    Google Scholar 

  • Wesnes K, Warburton DM (1984a) The effects of cigarettes of varying yield on rapid information processing performance. Psychopharmacology 82:338–342

    Google Scholar 

  • Wesnes K, Warburton DM (1984b) Effects of scopolamine and nicotine on human rapid information information processing performance. Psychopharmacology 82:147–150

    Google Scholar 

  • Wesnes K, Warburton DM, Matz B (1983) Effects of nicotine on stimulus sensitivity and response bias in a visual vigilance task. Neuropsychobiology 9:41–44

    Google Scholar 

  • Westman E, Levin E, Rose J (1995) Nicotine as a therapeutic drug. NC Med J 56:2–5

    Google Scholar 

  • Williams JBW (1988) A structured interview guide for the Hamilton depression rating scale. Arch Gen Psychiatry 45:742–747

    Google Scholar 

  • Wonnacott S, Irons J, Rapier C, Thorne B, Lunt GG (1989) Presynaptic modulation of transmitter release by nicotinic receptors. In: Nordberg A, Fuxe K, Holmstedt B, Sundwall A (ed) Progress in brain research. Elsevier Science Publishers B.V., New York, pp 157–163

    Google Scholar 

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Authors and Affiliations

  1. Department of Psychiatry, Neurobehavioral Research Laboratory, Box #3412, Duke University Medical Center, 27710, Durham, NC, USA

    E. D. Levin, C. K. Conners, E. Sparrow, S. C. Hinton, D. Erhardt, W. H. Meck, J. E. Rose & J. March

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  1. E. D. Levin
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  2. C. K. Conners
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  3. E. Sparrow
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  4. S. C. Hinton
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  5. D. Erhardt
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  6. W. H. Meck
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  7. J. E. Rose
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  8. J. March
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Levin, E.D., Conners, C.K., Sparrow, E. et al. Nicotine effects on adults with attention-deficit/hyperactivity disorder. Psychopharmacology 123, 55–63 (1996). https://doi.org/10.1007/BF02246281

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  • DOI: https://doi.org/10.1007/BF02246281

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