Trouble Concentrating? A Patch on the Arm Could Help
Dec. 2, 1999 (New York) -- The nicotine patch -- workhorse of the
stop-smoking movement -- may have earned a new job title. The patch may also
provide an alternative to Ritalin in treating disorganized, distracted,
forgetful adults who have moderate symptoms of Attention Deficit Hyperactivity
Disorder (ADHD), according to a report in the December issue of the American
Journal of Psychiatry.
Until now, stimulants like Ritalin and antidepressants have been the
standard treatment for ADHD. However, those who take Ritalin can experience
abdominal pain and, because the drug can suppress appetite, it often causes
weight loss. The most common adverse side effects of the nicotine patch were
dizziness, skin irritation, nausea, and headaches.
"This is the first clinical study of a very different class of [drugs]
for this disorder," lead author Timothy E. Wilens, MD, of Massachusetts
General Hospital/Harvard Medical School in Boston, tells WebMD. "Since most
adults come in for treatment of the cognitive ["attention-related"
symptoms] aspects of the disorder, this treatment shows promise," he
The study involved 32 adults between the ages 19 and 60 -- all diagnosed
with ADHD dating back to childhood -- and all with moderate-to-severe levels of
impairment. In the study, patients received two patches every morning
containing either the nicotine compound or a placebo. The patches were removed
at night. There were two 3-week treatment periods separated by a weeklong break
The investigators found that 47% of patients responded to the nicotine
treatment compared to 22% of the subjects on placebo -- and those with less
severe symptoms responded best to the nicotine treatment. All of the nine
symptoms of inattention and six of nine symptoms of hyperactivity/impulsivity
were significantly improved following treatment with the nicotine patch,
compared with five of 18 symptoms that improved with the placebo.
While the patch won't be a substitute for Ritalin and other ADHD treatments
"simply because it's not as robust a response," it provides an
alternative, says Wilens. "It may be added to other agents or may be used
for subtypes of individuals with ADHD."
The study was limited by its relatively small size and short duration,
Wilens adds. He suggests that future investigations should utilize higher
doses, more flexible dosing, and longer treatment trials, especially because
people were still continuing to improve at the end of his study.
"I think the Wilens' study is a good study, although further work is
needed," Edward D. Levin, PhD, of Duke University Medical Center in Durham,
N.C., tells WebMD. "Our findings are quite similar. We've done a few
studies looking at the effects of the nicotine skin patch on attentiveness in
adults with ADHD, schizophrenia, and Alzheimer's patients and found significant
improvement in attentional performance in all those groups."