Feb 022012

 Non-smoking seniors who were showing noticeable signs of cognitive decline regained 46 percent of their long-term memory loss after six months on the nicotine patch, along with boosts in concentration.

Those who got a placebo patch had memory loss plunging by another 26 percent over six months.

Everything comes with side effects, and nicotine is no exception.

The researchers behind the new study say the patients who took it consistently lost weight.

Is that a bad side effect?

The latest study, published in the Jan. 10 Neurology, involved 67 subjects with amnestic MCI randomized for six months to either placebo or 15 mg per day of transdermal nicotine.

The results found “significant nicotine-associated improvements in attention, memory, and psychomotor speed,” with excellent safety and tolerability.

The idea that nicotine would have positive therapeutic effects on brain function is still a novel idea to a lot of people,” said the senior author of the paper, Paul Newhouse, MD, professor of psychiatry, pharmacology and medicine, and director of the Center for Cognitive Medicine at Vanderbilt University School of Medicine in Nashville.

Nicotine obviously carries a lot of baggage,” he told Neurology Today, “but this paper is based on work we started doing in the late 1980s on the beneficial effects of nicotine in Alzheimer disease. There are now clinical trials of nicotine in Parkinson disease. What we’re trying to discover is the range of benefits.”

Dr. Newhouse has previously published studies showing that nicotine improves cognitive defects in young adults with ADHD.

Nicotinic receptors in the brain appear to work by regulating other receptor systems, like a gain amplifier,” he said. “If you’re sleepy, it tends to make you more alert.

If you’re anxious, it tends to calm you.

Obviously the results of small studies often aren’t replicated in larger studies, but at least nicotine certainly looks safe.

And we’ve seen absolutely no withdrawal symptoms.

There doesn’t seem to be any abuse liability whatsoever in taking nicotine by patch in non-smokers. That’s reassuring.”

But according to Dr. Newhouse, nicotine itself — not any of the subtypes now being studied and even developed into drugs by biotech companies — might yet prove to the most effective neuroprotective agent.

Nicotine has the advantage that it is kind of a dirty drug, it covers all types of nicotine receptors,” he said. “The selective agents that the pharmaceutical industry is studying may miss some subtypes that are important. That’s the puzzle: we haven’t yet figured out which subtypes matter most.”

The big pharmaceutical companies are trying to make a pill, would it be as effective as nicotine?.

A big question mark on that one, they have to develop an alternative so as to obtain a patent for their product.




Nicotine treatment of mild cognitive impairment A 6-month double-blind pilot clinical trial


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