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.
Please help. When i take my ADHD medication (adderall, concert or ritalin), i chain smoke like a chimney.
When i don’t take my meds, then i have NO desire to smoke. When i don’t take my meds, i can’t function and my life becomes a living hell.
I’ve tried straterra as a non-stimulant. While I don’t smoke while on it, it does NOT work.
I’ve tried the stimulant meds with wellbutrin but it doesn’t work.
Does anyone know of another medication I can take or supplement to the adhd meds i currently take.
I’m desperate at this point. I’m an attorney and cannot handle my work and personal life without the meds but can’t keep chain smoking. I also noticed that I am more likely to drink more alcohol while on the stimulant meds.
Any suggestions are welcome. All my doctors deny a link between stimulant meds and smoking. I feel so relieved to find that there are others that are experiencing the same thing.
I smoke about 6 or 7 cigs a day and diagnosed myself at 55 with ADD…ok maybe ADHD! ( It runs in the family) The combination of Menopause and moving to a ranch where there is no schedule to speak of threw me for a loop and that is how I figured it out that I had ADD…plus a counselor. I made it thru grad school too…not smoking either! Good idea not smoking when at the computer( a form of crack for ADDers!!) I find exercise is very important and yes Dragon Bone and Buplureum is excelent as it pulls you down out of your head and calms you. ( I’m an Acupuncturist) And my gandfather was diagnosed with RA at 19 and lived well into his 80′s also.
Smoking is an addiction not a habit just read a book by Allan Carr called quiting smoking is simple and you wont smoke anymore its just that easy!
I too have ADD and smoked for thirty years.I cannot take the traditional ADD meds as i am a recovering addict(meth,go figure) I found for me using an eletronic cigerette Just nicotine sans the 4000+ chemicals that make smoking so very dangerous.It is available at many sites online,I use ecig unlimted.It has hepled me greatly and it is cost effective depending on how much you smoke.I’m not saying to use this if you have never smoked. but in my humble opion if you want a smoking alturnitve this might be worth looking into.
best of luck and love to all,J
Just a quick caution to any non smokers that might want to try nicotine patch or gum for ADD – be careful. Nicotine can make you very sick until you build up a tolerance to it. If a non smoker put on a 21mg patch, they would get very sick very fast! Start with the 7mg and take if off at the first feeling of illness.
I’m using the patch to try to quit nicotine, but I can feel my ADD kicking up. The 21mg was great, the 14 is leaving me a bit foggy, and I hate to think of what the 7 will be like. I may have to seek other medication.
Hi,
I currently am “self-medicating” my attention deficit disorder with snus. It is a finely ground-up tobacco, which contains far fewer tobacco nitrosamines than cigarettes or snuff. You can also swallow the “juices”, though, it is a discouraging action – I try not to salivate on the pouches.
Anyways, I digress. I find nicotine is a far superior stimulant, than say – adderall or methlyphenidate. I feel calm, focused on multiple things (* rather than on one thing *), my thoughts seem to flow easily, and my anxiety is lowered to a manageable level.
I cannot afford nicotine gum, nor the patch. Though, I am contemplating in the future – when my finances can afford it, going on the patch in the long run. Nicotine is the only substance I have found, that allows me to break my hyperfocus – and see what’s going on around me.. It also helps me manage any depressing feelings I may have going on.
I wouldn’t be able to write this comment, constructively, without going on long tangents – digressing from the topic.
Don’t get me wrong, I’m not advocating nicotine, I’m just stating what it did for me. If something helps you, weigh out the benefits between the negatives, and decide what is in your best interest.
Regards,
Aric
My ADHD seemed to explode everytime I tried to quit smoking.
A couple of years ago I was finally able to stop smoking using Champix, which is VArenicline. After years of heavy battle with ADD with therapie and medicins, I decided to get back to smoking.
I was hoping to find some stuff on the possible use of CHampix to fight ADD aas it ia to me experience, way more efffective than stimulants. Just unsure about the effects of prolonged use.
I wold prefer using CHampix to smoking. But I prefer smoking to Other medicins, as wel.. despite the medicines, my house is a complete and utter mess after 3 or 4 years of not smoking…
And realy, I had no urge to smoke whatsoever. But Out of despeartion I recommenced smoking today. I really want to see where this is going, the research into Varenicline
I have to comment, as one who participated in some research for this non stimulant medication, not sure it was the one above listed, it was last year in the summertime. I quit smoking over 24 years ago. I went undiagnosed like most. I was put in “special ed classes” all through high school also. I quit high school, went back and finished my ged somehow and started college, prenursing, and found myself not finishing some clases, and got diagnosed luckily by a psychiatric counselfor at one of the colleges i attended. I have found it challenging finding the right med. I didnt get much help on the trial med non stimulant. Currently started on ritilin LA doing another study, and its working great! the LA (long acting) seems to help with the ups and downs that the takeing one every so many hours does, (as i had to with adderall).
OH, yeh, and by the way, i made it through LPN(licensed practical nurse) school while on focalin XR about 5 years ago, and currently working on my last 2 Rn (registered nursing) courses, and taking a break from it tho while getting stabilized on a med that is showing me so much hope. I could never have got this far without the right medication to help.