Nicotine and Behavior in Adult ADHD
Condition: ADHD
MeSH terms: Attention Deficit Disorder with Hyperactivity
Study type: Interventional

Summary: 
      Attention deficit hyperactivity disorder (ADHD) is characterized by inattention, impulsivity,
      and hyperactivity that are frequently treated with stimulant medications such as Ritalin.
      Many people with ADHD smoke. The smoking prevalence rates are estimated to be 40% in adults
      with ADHD compared to 20% in the general population. People with ADHD have also more
      difficulty to quit smoking. Only 29% of smokers with ADHD quit smoking compared to 48.5% of
      smokers in the general population. Nicotine is a stimulant, which may have properties similar
      to stimulant medications (e.g., Ritalin) used to treat ADHD. Nicotine may increase attention
      and reduce hyperactivity and impulsivity and, thus, may regulate behavior in individuals with
      ADHD. Alleviating the symptoms of ADHD and increasing cardiovascular activity through smoking
      may mimic the effects of stimulant medications and can be a form of self-medication.

      The major objective of the study was to examine the effects of nicotine on ADHD symptoms,
      moods, and cardiovascular activity. The study investigated the effects of nicotine patches on
      behavioral regulation in adult smokers and nonsmokers with ADHD. Smokers and nonsmokers with
      ADHD participated in two conditions: (1) nicotine patch and (2) placebo patch. During each
      condition, symptoms, moods, and side effects were assessed for 2 days during waking hours. An
      electronic handheld diary, programmed to prompt the participant twice per hour, recorded ADHD
      symptoms (e.g., difficulty concentrating, impulsivity, etc.), negative moods (e.g., anger,
      stress), and nicotine side effects (nausea, dizziness). Heart rate and blood pressure were
      recorded with lightweight ambulatory monitors to indicate cardiovascular activity. Results
      provided information about the effects of nicotine patches on behavioral regulation in adult
      smokers and nonsmokers with ADHD.

      The inclusion of nonsmokers was important to clarify whether the effects of nicotine on
      smokers was due to smoking withdrawal. The findings help explain the increased smoking
      prevalence rates and reduced quit rates associated with ADHD. Knowledge about nicotine's
      effects on behavioral regulation can help to develop successful smoking cessation programs
      for individuals with ADHD. The findings on cardiovascular activity may help determine the
      potential risk for cardiovascular disease in smokers and nonsmokers with ADHD. The study
      contributed to understanding nicotine's effects on behavioral regulation in a highly
      vulnerable population such as people with ADHD.
    


Intervention name(s): Nicotine; Placebo
Intervention type(s): Drug; Other
Intervention description(s): 21 mg nicotine patches for smokers for 2 days
7 mg nicotine patches for nonsmokers for 2 days; Placebo Patch
Intervention MeSH terms: Nicotine
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Basic Science
Keywords: Nicotine; ADHD; Gender