Clinical and attentional effects of acute nicotine treatment in Tourette's syndrome.

Abstract

Evidence from pre-clinical infrahuman investigations, open-label clinical trials, and a single controlled trial found acute nicotine treatment potentiated up to 4 weeks neuroleptic-induced reductions of dyskinetic symptoms characterizing Tourette's syndrome (TS). Given the attentional disturbances associated with this syndrome, and the improvements in attentional processes reported with nicotine, this randomized, double-blind, placebo-controlled trial examined the acute (4 h) and sustained (2 weeks) effects of a single dose of transdermal nicotine on clinical (i.e., tics), attentional (continuous performance task, event-related potential, patient and parental reports) and behavioral symptoms in 23 children and adolescents with TS receiving neuroleptic treatment. In the 14 evaluable patients with complete primary efficacy data, nicotine (compared to placebo) failed to alter symptoms at 4 h but counteracted ERP-P300 signs of diminished attention seen 2 weeks following placebo treatment. Secondary efficacy measures, including patient self-reports and parental ratings, found nicotine to reduce complex tics and improve behaviors related to inattention. Additional work with intermittent dosing schedules is required to characterize optimal clinical and cognitive effects with nicotine treatment.

• Authors: Anne L Howson, Sue Batth, Vadim Ilivitsky, Armand Boisjoli, Martine Jaworski, Colleen Mahoney, Verner J Knott
• Journal: European psychiatry : the journal of the Association of European Psychiatrists (Eur Psychiatry) Vol. 19 Issue 2 Pg. 102-12 (Apr 2004) ISSN: 0924-9338 [Print] England
• PMID: 15132126 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antipsychotic Agents
• Ganglionic Stimulants
• Nicotine

Topics

• Administration, Cutaneous
• Adolescent
• Analysis of Variance
• Antipsychotic Agents (therapeutic use)
• Attention (drug effects)
• Child
• Double-Blind Method
• Electroencephalography
• Evoked Potentials (drug effects)
• Female
• Ganglionic Stimulants (administration & dosage, adverse effects, therapeutic use)
• Humans
• Male
• Nicotine (administration & dosage, adverse effects, therapeutic use)
• Reaction Time (drug effects)
• Severity of Illness Index
• Task Performance and Analysis
• Time Factors
• Tourette Syndrome (drug therapy)
• Treatment Outcome
• Videotape Recording