You’ve seen the packaging: “This product contains nicotine which is a highly addictive substance.”
Now, would you be surprised to learn that nicotine has some therapeutic benefits, too?
When used on its own (as in, without the thousands of other harmful chemicals in cigarettes), nicotine has been found to have a number of therapeutic benefits for patients with various ailments, from ADHD to dementia and beyond.
Let’s take a closer look at some of the therapeutic benefits that nicotine has to offer.
- Nicotine can be therapeutic in treating cognitive issues stemming from ADHD, schizophrenia, dementia, and Alzheimer’s
- It may also benefit those with a rare form of epilepsy (ADSHE)
- Some patients with neurological conditions like Tourette’s syndrome and Parkinson’s disease benefit from nicotine therapy
- Nicotine is a fast-acting, short-lived stimulant which is generally considered safe
Nicotine for ADHD
ADHD—or, Attention Deficit Hyperactivity Disorder—is marked by a wide range of cognitive and behavioural symptoms beyond just difficulty concentrating. Those with ADHD suffer symptoms of inattentiveness, hyperactivity, and impulsiveness, among many other issues, and what was once thought to be a disorder of children (namely, young boys) is now increasingly being diagnosed and treated in adults.
The first line of medication treatment for those suffering from ADHD is stimulant therapy. This usually includes drugs like methylphenidate or amphetamine and their derivatives, which have a potential for abuse and a number of unpleasant side effects.
As we know, nicotine is a stimulant—and a fairly safe one at that (when used on its own in low to moderate doses). Because of this, there have been a number of studies looking into how nicotine may be therapeutic for ADHD symptoms—with positive results.
Studies show that individuals with ADHD are at a higher risk of taking up cigarette smoking. Even as smoking rates among the general population are in decline, rates among those with ADHD remain high. In fact, while roughly 20% of the population smokes, the number of people with ADHD who smoke is around 40%.
This is a case of self-medication, where those with ADHD either consciously or subconsciously realise that smoking masks their symptoms. But it’s not actually the smoking that helps—it’s the nicotine.
One small study from 2007 tested how the therapeutic administration of nicotine impacts cognitive function in young adults with ADHD by providing nicotine patches and asking the participants to conduct various cognitive tasks to test how the chemical would affect their symptoms.
The researchers found that administering nicotine via a transdermal patch led to cognitive improvements in several important areas central to ADHD, like distractibility and recognition memory.
Another small study tested this same hypothesis, this time in children and adolescents. And while the participants of the study reported more side effects than their adult counterparts did, the researchers found once again that nicotine was therapeutic in the treatment of ADHD.
- Many of those with ADHD self-medicate with nicotine
- 40% of those with ADHD smoke, compared to 20% of the general population
- Nicotine may help with inattention, cognition, and memory in people with ADHD
Nicotine for Narcolepsy
Narcolepsy is a neurological sleep disorder of REM sleep characterised by irregular sleep-wake patterns which lead to a host of symptoms—chiefly, excessive daytime sleepiness (EDS), among many other issues. In addition, a majority of people with narcolepsy have a symptom called cataplexy, which is an uncontrolled loss of muscle function that occurs when the person becomes excited, stressed, anxious, or otherwise emotionally stimulated.
One of the biggest symptoms of narcolepsy is called “sleep inertia,” which we’ve all experienced in our sleepiest states—but narcoleptics experience this on a regular (often daily), prolonged, and extreme basis. Sleep inertia is the state between sleep and wakefulness, where your cognitive performance is impaired and all you want to do is go back to sleep.
There is no cure for narcolepsy, and treatment currently centres around symptom management.
There’s an interesting case of a 17 year-old boy with narcolepsy who simply couldn’t wake up in the morning to take his medication. He was experiencing what’s called “morning sleep inertia.” Once he took his medication, he was fine going to school—but the biggest issue was simply getting him awake and out of bed long enough to take it.
The patient and his parents tried all the available traditional therapies to get him out of bed in the morning, but the boy was frequently late to school and was failing two of his classes as a result.
Then, his doctors had a novel idea: nicotine.
Nicotine is a fast-acting, short-term, and relatively safe stimulant with a half-life of just 2 hours. This makes nicotine one of the shortest-lived stimulants available, which is great for people with narcolepsy whose sleep-wake cycles are easily disturbed by substances like caffeine.
After receiving clearance from the boy’s paediatrician, the doctors prescribed something wholly unconventional: a nicotine patch, which his parents would apply to his arm while he was asleep roughly 20 minutes before it was time to wake up. Upon waking, he would remove the patch, wash off the residue, and take his daily medication.
The result? The patient was able to wake up for school and take his medication. He managed to graduate high school and participate in school events he would have otherwise slept through.
This is just one example of how nicotine has been found to have therapeutic benefits for people with narcolepsy. Another study found that narcoleptic smokers find relief from their symptoms when smoking or using nicotine products, as the short-acting stimulant helps to mask the sleepiness associated with narcolepsy. Nicotine has even been found to mask the symptoms of cataplexy in some narcoleptic individuals.
This is great news for narcoleptics who’ve found little relief from traditional therapies. Given that nicotine is considered a relatively safe and short-acting stimulant, therapeutic administration of nicotine could be the key to helping narcoleptic patients with treatment-resistant symptoms.
- Nicotine is a useful stimulant for narcolepsy because of its short half-life
- Using nicotine may help narcoleptics who have trouble waking up
Nicotine for Epilepsy
There is a rare and heritable form of epilepsy called autosomal dominant sleep-related hypermotor epilepsy (ADSHE) which causes seizures mainly during sleep. A person with this condition can experience up to 8 or more seizures per night, with the episodes increasing in complexity and duration as the night goes on.
The condition is caused by genetic variants of the neuronal nicotinic acetylcholine receptor (nAChR), and for approximately 30% of sufferers, treatment doesn’t help curtail symptoms.
Doctors and researchers have found that patients with a treatment-resistant form of this condition benefit from nicotine consumption, which is likely because the condition stems from a variation in a nicotine receptor. Studies have been carried out both in adults and children with astounding results.
One very small study from 2020 treated three young boys (two aged 10 years, one aged 6 years) with ADSHE by giving them a low-dose transdermal nicotine patch.
The researchers reported a “striking seizure reduction” soon after the start of treatment. In the three boys, all seizures disappeared, and only sporadic arousals and some movement were observed after starting treatment. In addition, psychometric testing revealed improvements in a number of cognitive areas, including memory and processing speed.
One journal article lays out the very same treatment in two brothers, aged 14 and 16 years. The brothers, who both had ADSHE, were given a low-dose nicotine patch. The very first night they used the patches, the seizures completely stopped in both boys. At the time of the article’s publication, the boys had been completely seizure-free for 18 months.
This is great news for people with this condition, and for those experiencing other forms of frontal lobe epilepsy. Research is still ongoing as to how nicotine may be therapeutic in the treatment of various forms of epilepsy—specifically, frontal lobe epilepsy—but for now, we know that it helps with treatment-resistant ADSHE.
- Nicotine has been shown to eliminate seizures in patients with ADSHE
- Most patients saw seizure reduction immediately upon starting treatment
- More research is needed to see if nicotine could help other forms of frontal lobe epilepsy
Nicotine for Dementia & Alzheimer’s
It’s no secret that the natural ageing process often brings about cognitive decline, particularly in the case of dementia and Alzheimer’s Disease. Researchers have found a fascinating link between nicotine and cognition, and this link may prove to be key in the future treatment of age-related cognitive decline.
Recent developments in the world of medicine have pointed to a number of neurological and cognitive benefits related to the ingestion of nicotine, including a decreased risk of both dementia and Alzheimer’s for regular nicotine users.
And for those already suffering, research has proven that nicotine can help to ameliorate or even slow cognitive decline.
Studies show that nicotine has a therapeutic effect on attention, information processing, and short-term memory in patients with dementia of the Alzheimer type (DAT). Both animal studies and human trials have found that activation of nicotine receptors in the brain can help improve functioning following ageing or the development of dementia, and can even slow the progression of these neurodegenerative illnesses.
Researchers used transdermal nicotine patches, which are a safe and measured way of administering nicotine for those with cognitive impairments related to dementia and Alzheimer’s Disease.
Researchers believe that nicotine significantly improves “attentional function” in these patients and may help to slow the cognitive decline associated with dementia and Alzheimer’s Disease, though more research is needed before a safe and effective universal treatment can be developed.
Still, we now know that nicotine carries potential therapeutic benefits which may slow the progression of these neurodegenerative diseases.
- Nicotine is proven to lower your risk of developing dementia and Alzheimer’s Disease
- It may improve symptoms in people with age-related cognitive decline
- It’s shown to “significantly improve” cognition in dementia and Alzheimer’s patients
Nicotine for Tourette’s Syndrome
Tourette’s syndrome is a neurological disorder which causes involuntary movements and sounds, called “tics.” This usually presents in childhood, and tics usually include uncontrollable movements and/or vocalisations. Frequency of tics may be worsened by stress, anxiety, or tiredness, according to the NHS. There is no cure for Tourette’s syndrome, and treatment of the condition centres around symptom management.
Most cases of Tourette’s are mild, and many of those who do seek treatment are able to manage with behavioural therapies. But for others, tics are severe and may interfere with daily activities. Plus, a select subset of those with Tourette’s syndrome experience pain from repeated movements, such as jerking the neck or shrugging the shoulders.
For those with severe symptoms, neuroleptics (also known as antipsychotics) like haloperidol may help—emphasis on may.
One clinical trial treated 70 treatment-resistant patients with a combination of haloperidol and either a transdermal nicotine patch or a placebo patch. The study found that the patients who used the nicotine patch saw a significant improvement in their symptoms when taking the haloperidol, but also, when the haloperidol dose was lowered by 50%, and when the patch was discontinued for 2 weeks. The researchers note that the nicotine patch was superior to the placebo patch in reducing symptoms of Tourette’s.
Another clinical trial tested the very same hypothesis in children and adolescents. And while the effects of the nicotine patch weren’t immediate, those who completed the course of treatment saw an improvement in complex tics and inattention thanks to the nicotine administration.
It seems we do have a ways to go before we can fully understand how the therapeutic use of nicotine may be beneficial in the treatment of severe Tourette’s syndrome, but the research is promising!
- Alongside haloperidol, nicotine can ease symptoms of severe, treatment-resistant Tourette’s
- Combining nicotine with neuroleptics was shown to be more effective than the medication alone
Conclusion: Nicotine Can Be Therapeutic
Why does nobody talk about the therapeutic benefits of nicotine?
Of course, there is the elephant in the room: smoking. If you told everyone with ADHD that nicotine would help their attention deficits, many would flock to buy cigarettes before considering a safer option, such as vaping or NRT options like patches or gum.
Perhaps this is why we don’t have more research into the therapeutic benefits of nicotine just yet. But based on what we do know so far, I’d say this warrants further research, especially in the realms of mental health and cognition.
Our society is growing ever more mentally ill while an entire generation is ageing fast—and if nicotine can benefit these people, we should certainly be exploring it more.
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