ANTIDEPRESSANT EFFECT OF TRANSDERMAL NICOTINE PATCHES IN NONSMOKING PATIENTS WITH MAJOR DEPRESSION

Background: A high frequency of cigarette smoking has been reported am ong individuals with major depression. In a previous study, transderma l nicotine produced short-term improvement in the mood of depressed pa tients. This study was undertaken to determine the effects of 4 days' administration of transdermal nicotine on mood in nonsmoking patients with major depression. Method: The effects of nicotine patches (17.5 m g) on 12 nonmedicated outpatients with major depression (DSM-III-R) we re studied for 4 continuous days. Patients had to score 18 points or m ore on the Hamilton Rating Scale for Depression (HAM-D) (21 items) for admission into the study. The HAM-D (10 items), a visual analog scale , and a side effects scale were scored daily during the trial (baselin e, 4 days of nicotine patches, and 4 days of follow-up). Results: Two patients dropped out of the study owing to nausea and vomiting. Result s of the visual analog scale and HAM-D (10 items) showed a significant (p <.01) improvement in depression after the second day of nicotine p atches. Patients relapsed 3 or 4 days after the last nicotine dose. Th e side effects observed were an increase in saliva production, nausea, loss of appetite, and mild insomnia. Conclusion: Nicotine patches pro duced shortterm improvement of depression with minor side effects. Bec ause of nicotine's high risk to health, nicotine patches are not recom mended for clinical use in depression. Analogue drugs may be developed in the future that may help improve depression without the risk of ot her major health problems.