RITALIN(TM) FOR NICOTINE WITHDRAWAL - NESBITTS PARADOX REVISITED

This was a unblinded clinical trial of the stimulant methylphenidate ( Ritalin(TM)) for nicotine withdrawal. Nineteen nicotine-dependent smok ers received oral methylphenidate (30 mg target daily dosage) for 5 da ys following abrupt cessation. Tobacco withdrawal, Spielberger state a nxiety, blood pressure, and pulse were measured at baseline, then seri ally for 7 days. Tobacco withdrawal and state anxiety increased signif icantly, but 12 (71%) of the 17 smokers who completed the study rated withdrawal relief ''very definite'' and 13 (76%) rated this quit attem pt ''much easier than other times.'' Methylphenidate neither increased blood pressure nor blocked cessation-related pulse decrease and appea rs safe for this indication. Twelve (63%) of the enrolled smokers were confirmed abstinent at day 5. Methylphenidate effect on nicotine with drawal should be studied in a placebo-controlled clinical trial.