ADHD Medication: Is Nicotine Next?
ByJust ask any smoker – nicotine can help you focus. However, we all know that smoking cigarettes is very bad for your health.
Well, it seems that the new frontier in ADHD medication relates to how nicotine receptors can improve concentration.
Currently, there are the stimulant medicines for ADHD (like Concerta, Vyvanse, Adderall, etc), and there is one non-stimulant approved for ADHD (Strattera).
New research is investigating medicines which work on the nicotinic receptors – hoping that these medicines will improve concentration, and become another non-stimulant option for ADD/ADHD.
There are two recent references for this:
1) ABT-894: This is a compound which is in early trials. It was being studied for chronic pain – though it was not helpful for that clinical population. It was also tested in almost 200 adults with ADD – and found to be helpful. More research is needed to see if it could be approved for ADD/ADHD, though this looks promising -and exciting if we could get a new medicine with a completely different mechanism of action.
You can read about ABT 894 for ADHD here.
2) Varenicline: This is also a medicine which is a non-stimulant. It is used to treat nicotine dependence. There was a case report published suggesting that this medicine may help Adult ADD. As one case report -this does not constitute very strong research evidence – but nonetheless, it may be indicating a possible treatment – which merits further research. You can read the case report here. Take note of the scientific references which are written up at the bottom of the case report.
These reports suggest that new non-stimulant medicines which focus on the nicotine receptors in the brain may provide great results in the coming future. Watch this blog for further updates over time.
DO NOT consider this a justification for continuing to smoke. Smoking is very negative for your health – and will not help you over time. Work with your doctor to find the right treatment for you – and just realize that in a few years – there may be new options to consider.
Please share your thoughts and comments below.
Best,
Dr. Kenny
Technorati Tags: ADD, ADHD, Nicotine, Smoking, Vyvanse, Adderall, Varenicline, Medication
I started smoking when I was 24 to enhance my concentration. Little did I know at the time the reason was because of my undiagnosed ADHD.
I write about self-medication in my book, “Dear Mary: My Life with ADHD.”
Dr. Handleman,
What about nicotine substitutes, such as the “patch” or nicorette gum? I’m not a smoker – but I am considering picking up a pack this gum the next time a deadline is looming – surely it can’t be more toxic than a full-on prescription drug?
Thanks
I would generally advise against that and strongly encourage you to talk to your doctor before doing that.
The new medicines they are researching will work on the nicotinic receptors but not necessarily be the same as nicotine.
I’m 47, diagnosed w/ADD last November, started w/Ritallin generic, didn’t like the ups/downs of taking 3 20 mg pills/day, tried Concerta last month, 72 mg in AM, to try and get a more steady stream of med, but it wasn’t working very good. I think it wasn’t strong enough. Considering Adderall XR or Vyvanse. I think my girlfriend of 3 yrs has ADD. She smokes about a pack a day, and a few cups of coffee. I really think it helps her ADD. She has RA (Rheum. Arth.) & says she doesn’t expect to live a long life anyway. I tell her new medicines come out all the time. I don’t think she’d admit to having ADD. As for the gum and patch, they have nicotine just like cigs, they just deliver it differently to try and get you off the habit of smoking. Most are from the same cig companies and I think just trying to hook people another way. ADHD drugs don’t have the risk of cancer and all the other health risks. They just take some time to find the one that will work long term, and the dose that is right for you. If it isn’t working or stops after a week the dose could need increasing. If it is making you feel too jittery, and too much like being on speed then it probably needs decreasing.
Dr. Handelman,
I love your site. Very informative and kept current. Your video interviews are also great resources. I would love to find a site that lets ADD/ADHDers post a journal as time goes on of the meds they are taking and how they are doing. People could post comments/suggestions/questions. Has anyone seen something like that?
Hi Bob,
Thanks for the compliment. I’d glad you like http://www.adhd.tv
My laptop has been under repair for several weeks – so I’ve been ‘behind the times’. I’ll start with more new content again – because I just got it back!
Anyway – you can use http://www.adhdworld.com Many people have posted their progress with medication on this social network site.
I have another ‘secret project’ in the works which may help with that… but that is likely months away. If you are on my email list, you’ll get the updates when it’s ready.
Best,
Dr. Kenny
Dr. Handleman,
I am 35 and FINALLY ready to admit that something is wrong and I need help.
I suspected in college, and especially in graduate school, that I had at least some symptoms of ADD, but I was unwilling to admit I might have problem I couldn’t deal with without mediation. After all, I made it through graduate school!
In the last few years, though, the symptoms have begun to make me feel like I’m losing my mind. (The magic a ability to walk into a room, set down my car keys, and lose them within 90 seconds especially makes me feel like I’m incompetent!) My inability to even WORK on a project (much less finish it) until the deadline is, well, tomorrow, is affecting my job and the people with whom I work. I’m sure you’ve heard these things before, so I will stop. I WILL say that I’ve done enough research a this point that I have an appointment with my physician to discuss an ADD diagnosis and treatment and/or a referral to a psychiatrist. And I’m VERY excited about the possibility of getting help.
The reason I am posting here is that I couldn’t figure-out until recently why my symptoms suddenly became more than I could bear. I don’t think the symptoms are supposed to get worse with age. I made it through grade school (and a lot of college) just be being pretty darn smart and good at tests, but graduate school wasn’t for the faint of heart – it took effort – for everyone, regardless of ADD. So why is it that in the last two or three years, it’s become more that I can take? Why is it so bad now that I’m driving people away? Why do I have to write down EVERYTHING now, rather than just the things I want to remember to do tomorrow or in the future? Then it hit me. I QUIT SMOKING NEARLY THREE YEARS AGO. I started when I was 17. I quit for a little while, between college and grad school, but started again while studying for my grad school entrance exam. I smoked my way through higher education!
I started thinking… ADD is treated with stimulants, right? And nicotine is a stimulant, right? So what if the stimulant in nicotine gave me just enough help to manage my issues. Now I am NOT saying I think smoking would be preferable to a drug intended to treat ADD, but is it possible that quitting smoking is the reason I FEEL like I’ve gotten worse?
That’s when research mode kicked-in. Unfortunately, there is very little information available. (I suspect that, if this theory is correct, no one wants to advertise it, since it might encourage smoking. Of course, that’s really not a good reason to hide information. We just need to focus on the idea that if nicotine actually helps ADD, then medication designed for ADD might work miracles!)
Anyway, I would REALLY like any additional information or references you have on the subject of smoking and ADD. I’m going to see my physician Friday about a diagnosis, and I really want to be prepared. (I have mentioned the possibility before, both to her and to other physicians, and I have basically been “blown-off”. I think they figure that if I made it this far, either I’m not ADD, or I’m not ADD enough to need meds. This time, I will not be blown-off. If she won’t help me, I’m getting a referral to a psychiatrist.)
Thank you very much for your time!
i would rather go untreated (by medication) than use nicoteen. it is sick, it’s a poison and should be removed from the earth. Smoking has caused two of my unkles to die of lung cancer, it will not get me.
Hey all…..
I quit smoking with the use of the patch (for the second time) last fall, and because I liked the feeling that it gave me — i was more even, less prone to sudden burst of anger, and could concentrate better — I decided to heck with it, I’m not going off. And what I really like is that while it doesn’t have the initial amazing calmness and focus I got with Adderall, it didn’t devolve into 10 percent of its efficacy after a few months either. I put it on every day, and have no plans to go off. And all this time I theorized that I bet nicotine would be good for people with ADD….and so I googled the two together and found this article!
I bet if you do a study on all the people who can’t give up the gum or who really really have trouble quitting, I bet 95% have ADD. I read that Augusten Burroughs is a total addict of the gum — chews like 40 pieces a day — and if he doesn’t have ADD, then no one does.
I smoke about 6 cigaretes a day. I don’t allow myself to smoke while driving or talking on the phone or computer( my weakness)…well most of the time any way. I try to only smoke when I can really stop and enjoy it. No impulsive stuff. I think I will try the patch…need to quit. Also the Chinese Herbal formula “Dragon Bone and Buplureum”calms tremendously. ( I’ve taken it and people noticed the difference in me.)Guess I need to practice what I preach!! Any how this is a comment to the guy who’s girlfriend has RA. My grandfather had it and lived to 86!He was diagnosed at 18.