Drug info - Article: Nicotine, Tobacco & Tourette Syndrome

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Nicotine, Tobacco & Tourette Syndrome

Let us start out with this note: We are not advising people to take up smoking for their health or to cure Tourette Syndrome.

It has been known since the early 1980's that nicotine - a natural product derived from the tobacco plant - plays an important role in the brain. Researchers think that nicotine acts by stimulating the chemicals which play a fundamental role in transmitting messages between nerves and across brain neurochemicals.

Whether from a puff on a cigarette, chewing nicotine gum, or a nicotine patch stuck to the skin, nicotine shifts the body into high gear as the drug enters the bloodstream. Scientists generally attribute nicotine's power solely to the activity it sparks in the brain. The stimulation can make users feel good, even euphoric. It's also what makes them crave more. Physicians, however, generally finger tobacco's thousands of other chemical constituents, including known carcinogens - not nicotine - for smoking tobacco cigarettes' nastiest side effects. Therefore researchers caution that smoking is a bad way to get medical nicotine for any reason including Tourette Syndrome.

The properties that make nicotine a health hazard might also make it a useful therapy for more than smoking cessation. "Nicotine is a drug—not a poison or carcinogen—but a drug," says Sergei A. Grando of the University of California, Davis. "Nicotine is often a bad guy," he adds, "but it can also be a good guy."

The challenge in any of nicotine's possible uses is to identify people for whom the drug's benefits outweigh its risks and to develop targeted delivery methods, says Phillip A. Dennis of the National Cancer Institute in Bethesda, Md.

Nicotine and Tourette Syndrome Trial

In Tourette Syndrome nicotine is thought to work by regulating the brain's levels of message-carrying chemicals, such as dopamine and acetylcholine. Tourette Syndrome patients may have excessive levels of dopamine in the brain and are treated with drugs that block dopamine. Therefore regulating the brain's use of dopamine may reduce some of the Tourette symptoms - but not everyone responds to every medication used.

The researchers are not entirely sure how it works, but suggest that by latching onto a "nicotine receptor" on brain cells, it stops the receptor playing its role in the mechanism of Tourette's instead.

So having shown experimentally how a small dose of nicotine can greatly increase the effect of a dopamine blocker in animals, Dr. Paul R. Sanberg of the University of South Florida wanted to add nicotine to the treatment of the Tourette Syndrome patients.

Professor Sanberg discussed his research at a conference of the American Association for the Advancement of Science in Washington February 21, 2000.

In the eight-week study, Sanberg's team randomly assigned 70 young Tourette's patients to either nicotine patches or placebo patches.

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patch_dr.jpgThe nicotine patch - also called the nicotine transdermal system is like a bandage applied to the skin and may cause a mild itching or burning sensation in the skin. This usually disappears within 60 minutes. If a skin rash, redness or swelling appears, a doctor should be consulted. The nicotine patch can cause excessive irritation to those with allergies or other skin problems.
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On average, the patients on the nicotine patches were able to cut their dosage of Haldol, a potent tranquilizer used to treat Tourette's with a number of undesirable side effects, by about half, Sanberg says.

Dr Archie Silver, who was involved with the research, said: "Not only was the patch effective, but a much smaller dose of the medication Haldol could be given. "That's especially important when treating children or adolescents."

Initially they used nicotine gum - and within half-an-hour, many of their tics had stopped. The patients were able to focus better, and the children's parents reported that they do their homework and write better. The vocal tics - blurting out vulgar words - were also reduced. They saw quite a few benefits which lasted a few hours.

The greatest problem, however, was getting children to use the nicotine gum properly as they hated it. "Nicotine gum tastes very bitter" says Professor Sanberg " so instead of doing what they were supposed to do, which is bite it and park it in their cheek where the nicotine could be absorbed, they would chew it like bubblegum, swallow the stuff and then get gastro-effects like wanting to throw up. It was terrible."

Side-effects

Unfortunately, some children did suffer increased side-effects, such as nausea and dizziness. Nausea, a slightly increased heart rate, and itchiness from the patch were the main side effects.

The researchers said that there was no evidence that the children became dependent on nicotine. It might help that the patches release nicotine slowly so that it reaches its peak in the blood in about three hours, much slower than when smoking a cigarette.

They also note that patches may only be suitable for those whose symptoms cannot be controlled any other way.

More research is needed before nicotine patches become routine to treat diseases. However, Sanberg said that if Tourette's patients cannot control their symptoms with standard drugs, a low-dose patch might be worth trying.

Also Sanberg notes, "I think that nobody is saying per se that nicotine is the right answer for these disorders - but the studies show that if it does work, there are a number of drug companies out there who have nicotine programmes. That´s to say they're designing new novel drugs that are similar to nicotine, that will act at the nicotine system in the brain, and maybe have more specific and fewer side-effects. So they could be beneficial in these other diseases."

“Now that we understand more about how nicotine works in the brain, we're looking for nicotine substitutes that could more precisely target specific brain disorders and have fewer side-effects than the patches."

Since no drug firms have exclusive rights to nicotine, researchers say companies have little interest in paying for studies to prove its health benefits. However, several are working on nicotine substitutes that can be patented. These drugs could be more precisely targeted against specific disorders, carry fewer side effects, and be available as pills rather than patches.

Dr. Sanberg said, another study reported in the Journal of the American Academy of Child and Adolescent Psychiatry, found that the drug mecamylamine (Inversine) appeared to be safe for children and to help those who experience mood disorders such as depression, aggression or anxiety along with Tourette's syndrome. Further research is needed to determine if mecamylamine can also boost Haldol's effectiveness in reducing motor tics in the same way that nicotine does. The mecamylamine study was funded by Layton Bioscience Inc.

http://www.tourettes-disorder.com/therapy/nicotine.html

Reputation Comments on this post:

Interesting article, thanks.