Nicotine May Help Calm ADHD Storm, Study Finds

Research shows that adolescents with attention deficit hyperactivity disorder smoke at twice the rate of normal adolescents and as adults, they have a harder time quitting than their counterparts without ADHD. Neuroscientists like Alexandra Potter, a post-doctoral associate in psychiatry, want to know why smoking is so attractive to the ADHD population.

For the past several years, Potter has examined the effects of nicotine in the form of transdermal patches on cognition in adolescents with ADHD. She says the real challenge in ADHD patients is not truly a deficit in attention, but rather an issue of attentional control, or keeping focused on the task at hand. The ability to maintain focused attention and to control impulsive behavior is known as inhibition. For an ADHD patient, that is the real problem. And, it turns out, thats where nicotine plays a role.

Potter's inhibition research uses a computer program that asks the study participant to type an x or o, then beeps to tell the participant to stop. Because of ADHD, the adolescent cannot stop. Potter's first study, which was presented at the Society for Biological Psychiatry and at last week's Society for Neuroscience meetings, compared how well kids with ADHD performed on this computer-response test when taking Ritalin, nicotine and a placebo. Nicotine was shown to be as good or better than Ritalin at eliciting a normal inhibition response from the group, which consisted of eight adolescents with ADHD. Each participant came in for a total of three days during which they received a patch and a pill, one or both of which were placebo, in order to double-blind the study.

"Our research indicates that both nicotine and Ritalin improve inhibition, and, in fact, bring the performance of adolescents with ADHD into the range of normal adolesence. We believe that this is related to the effect of nicotine on dopamine in the brain," says Potter.

She is now working on an investigator-initiated study funded by Targacept, Inc., a privately-held research and development pharmaceutical company that is focused on the development of nicotine-like therapies. Potter is continuing to look at nicotine's effect on cognition. This time, however, she is using nicotine, a placebo and three different days of ultra-low doses of mecamylamine a drug developed in the 1950s that is active at the brain's nicotinic receptors. The study will take place in UVMs General Clinical Research Center.

"But nicotine itself isn't the therapy of choice," says Potter. "The amount of nicotine needed to get positive effects in ADHD patients is close to a level that produces negative side effects. Our hope is to help develop better therapeutics that may work similarly to nicotine without its side effects."

According to Potter, finding a more effective treatment for adolescents with ADHD would likely reduce smoking among this population, because it would reduce their use of cigarettes to self-medicate their ADHD symptoms.

To find out more about Potters study, which is seeking 13=- to 25-year-old ADHD patients who are nonsmokers, call Sally Ross Nolan in the Clinical Neuroscience Research Center at 847-9488.