NICOTINE EFFECTS ON ADULTS WITH ATTENTION-DEFICIT HYPERACTIVITY DISORDER

Several lines of evidence suggest that nicotine may be useful in treat ing the symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD). T he current study was an acute, placebo-controlled double-blind experim ent to determine whether nicotine might be useful as an alternative tr eatment of adults with ADHD symptomatology. Six smokers and 11 nonsmok ers who were outpatient referrals for ADHD were diagnosed by DSM-IV cr iteria. Measures of treatment effect included the Clinical Global Impr essions (CGI) scale, Hopkins' symptom check list (SCL-90-R), the Profi le of Mood States (POMS), Conners' computerized Continuous Performance Test (CPT), the Stroop test, and an interval-timing task. The smokers underwent overnight deprivation from smoking and were given a 21 mg/d ay nicotine skin patch for 4.5 h during a morning session. The nonsmok ers were given a 7 mg/day nicotine skin patch for 4.5 h during a morni ng session. Active and placebo patches were given in a counterbalanced order approximately 1 week apart. Nicotine caused a significant overa ll nicotine-induced improvement on the CGI. This effect was significan t when only the nonsmokers were considered, which indicated that it wa s not due merely to withdrawal relief. Nicotine caused significantly i ncreased vigor as measured by the POMS test. Nicotine caused an overal l significant reduction in reaction time (RT) on the CPT, Ils well as, with the smokers, a significant reduction ill another index of inatte ntion, variability in reaction time over trial blocks. Nicotine improv ed accuracy of time estimation and lowered variability of time-estimat ion response curves. Because improvements occurred among nonsmokers, t he nicotine effect apl,ears not to be merely a relief of withdrawal sy mptoms. It is concluded that nicotine deserves further clinical trials with ADHD.