Could a nicotine patch slow dementia?
January 9th, 2012
04:00 PM ET

Could a nicotine patch slow dementia?

It's hard to escape the warnings of the dangers of smoking, but one component of cigarettes - nicotine - might actually have a therapeutic use, preliminary research suggests.

A small study, published Monday in the journal Neurology, finds that using a nicotine patch may help symptoms of mild cognitive impairment, a condition characterized by a noticeable memory problem.  Many, but not all, patients with mild cognitive impairment will go on to develop Alzheimer's disease; scientists are still working on predicting who is most at risk.

A nicotine patch releases nicotine slowly over a number of hours. It gets into the blood stream, travels to the brain and interacts with receptors on nerve cells. In particular, it seems to activate receptors on nerve cells important for a circuit involved in attention, learning and memory.

Dr. Paul Newhouse of the University of Vermont Medical School and colleagues studied 74 people and saw improvement in measures of attention, memory and mental processing among those who received the nicotine patch treatment over six months. But it's hard to say whether these patients recovered fully because they were not tested before developing memory problems.

"I think nicotine could be one of the answers we end up with" for memory decline, Newhouse said.  Multiple strategies will be needed to combat Alzheimer's disease; nicotine "may not be the only answer, but could be one of the answers," he said.

But Bill Thies, Chief Medical and Scientific Officer of the Alzheimer's Association, urges caution. Certain drugs that are approved for Alzheimer's disease, called anticholinesterase drugs (such as Aricept), slow the breakdown of the brain chemical acetylcholine.  Acetylecholine in memory circuits works on nicotinic receptors.  So it's not surprising to Thies that nicotine would show similar benefits.

"The course of the disease eventually overwhelms the effect of the medications, so they work for a few months and then they start to drop off," he said.  It's possible that the same decline in effectiveness would also occur with nicotine after a matter of months.

The study did not address what impact nicotine would have in combination with these anticholinesterase drugs, he said.

And nicotine is not entirely innocuous. Studies have shown that smoking is a risk factor for Alzheimer's.  Researchers do not recommend smoking to get the benefits of nicotine described in this study, nor do they advocate using nicotine patches for the purposes of cognitive benefits.

Also, if a person uses a nicotine patch for years at a time, there may be side effects including in cardiovascular disease, although this is not proven, Thies said.

All 74 participants in this study were nonsmokers.  The only consistent side effect observed was a small amount of weight loss, which isn't surprising since nicotine is an appetite suppressant.

Nicotine patches retail about $2.30 to $2.85 per patch on Amazon.com, depending on which company and quantity per box you choose. For the purpose of smoking cessation, nicotine patch regimens usually involve using one patch per day for eight to 10 weeks (although they may help more with withdrawal then staying away from cigarettes, a new study shows).

Memory loss isn't the only area where nicotine is being considered, such as Tourette syndrome.  Newhouse presented a pilot study on Parkinson's disease back in 2000.  There has been pharmaceutical interest in using nicotine-like drugs for pain control and bowl disease

Delivering nicotine by way of a patch is more efficient than through a pill, since the patch doesn't affect the liver or stomach, which would suffer side effects, Newhouse said.

Newhouse's group is going to propose a larger trial for a longer period of time.  The scientists want to get at the issue of whether this improvement effect would last - specifically, how much longer than the six months reported in this initial study.

Nicotine patches are not approved by the U.S. Food and Drug Administration for this purpose of treating patients with mild cognitive impairment.  For that matter, there is no FDA-sanctioned treatment for mild cognitive impairment at all.

There is the potential for nicotine to protect against further deterioration, but so far nothing has been found to slow the progression of Alzheimer's. Experts agree that whatever intervention works will probably have to be given as early as possible in the course of the disease.

If people or their families are noticing memory problems, they should seek an evaluation from a doctor, Newhouse said.

soundoff (64 Responses)
  1. Big John's

    So from this information we can assume that electronic cigerattes would help as well as the patch and better then pills or tobacco since there is no harmfull additives and no harm to stomach or liver.

    January 9, 2012 at 17:52 | Report abuse | Reply
    • medical student

      electronic cigarettes likely cause cancer, as you are heating up plastic (fumes from many plastics are known carcinogens), and they are not tightly regulated. No studies have been done to conclude they are in fact safe.

      Also, nicotine patches releasing a slow release of nicotine is not the same as a quick spike of nicotine from a cigarette or e-cigarette.

      So no I wouldn't conclude that.

      January 9, 2012 at 21:05 | Report abuse |
    • Elizabeth

      I would plead with any medical student to study B-vitamin deficiencies, and FORGET about nicotine.
      Yes, nicotine CAUSES memory problems: the first problem is SANE medical care.
      Look up B-12 deficiency, niacin deficiency, etc. Each has its own horror, and with a lack of "intrinsic factor" in the intestines, even if a person eats good sources for these vitamins, or takes pills, they could be deficient to the point of brain damage.

      January 9, 2012 at 22:38 | Report abuse |
    • RenDoc

      Elizabeth, you really should stay within your realm of expertise, whatever that is. Don't give advice to medical students because you don't seem to know what you're talking about. B vitamin deficiency is a standard topic in medical school curricula. It is not necessary to 'advise' medical students to study it. Secondly, topics like nicotine effects on dementia are exactly what med students (and doctors) should be studying because it's innovative. That's what allows our medical community to progress. It is the way forward. Lastly, you're ramblings about intrinsic factor deficiency only tells part of the story. It's obvious you're trying to sound more knowledgeable than you are. Let me guess, a nurse. Don't forget effects of vegetarian diets and proton pump inhibitor therapy as important causes of B12 deficiency. Hope to you take too much offense, but you probably will.

      January 10, 2012 at 02:14 | Report abuse |
    • Frangible

      "Let me guess, a nurse." haha, oh wow. Your office must be a fun place.

      And you give Elizabeth here too much credit. Nurses have to take science courses.

      January 10, 2012 at 10:34 | Report abuse |
    • Vaper

      My e-cig clearomizer is made of pyrex and stainless steel, so I'm not heating plastic while vaping.

      November 17, 2013 at 22:30 | Report abuse |
  2. Big John's

    Looks like now that the drug giants have put the tobacco companies out of business they are now going after each other for the business. http://www.huffingtonpost.com/audrey-silk/smoking-bans_b_1181618.html

    January 9, 2012 at 17:57 | Report abuse | Reply
    • RenDoc

      Big Johns, There has not been enough use of smoke cessation products to put tobacco companies out of business. That statement is preposterous. Secondly, how would that be a bad thing if it were true?

      January 10, 2012 at 02:40 | Report abuse |
  3. CaliMafia

    Hey, it worked for me. And they taste good, too. The only side effect is that I'm psychotic...............and delusional. Oh, well, it's worth it...........I think. Mebbe.................I don't really remember.

    January 9, 2012 at 18:07 | Report abuse | Reply
  4. drew

    Woo hoo! Now smoking is good for you...lol

    January 9, 2012 at 18:20 | Report abuse | Reply
    • MadTheAlbino

      No one ever said smoking was good, or even not as bad as it used to be. Getting patched up is not the same as having a smoke.

      Ever bothersome, J. L.

      January 9, 2012 at 21:23 | Report abuse |
  5. Observer

    Nicotine may help prevent or slow dementia but cigarette smokers haven't survived long enough to find out.

    January 9, 2012 at 20:09 | Report abuse | Reply
    • dwerbil

      Half a million American lives are cut short (drop dead) from tobacco use. I call that one hell of a defective product.

      January 9, 2012 at 20:54 | Report abuse |
    • SkekLach

      Quite the preposterous statement. Smoking isn't a disease. Despite what organizations like Truth would like you to believe, it doesn't infect you and you die 8-10 years later. My grandfather smoked from his early twenties until he passed away a week before what would have been his 78th birthday. My grandmother has smoked since her twenties and is in her 70's now as well. Short of the heart attack that took my grandfather from us, the most severe health ailment I've ever seen between the two was a bout of arthritis he had when I was young. Smoking CAN cause health problems, but it's not a death sentence or a virus. I'm not trying to promote smoking, but let's at least get our facts straight.

      January 10, 2012 at 08:10 | Report abuse |
  6. Frankster

    Nicotine in any form shrinks the artery walls, raises blood pressure, and causes the heart to work harder to pump the same volume of blood, hence the increases hear-rate associated with it. Nicotine can cause heart attacks. This much is known for certain.

    January 9, 2012 at 20:58 | Report abuse | Reply
    • Frankster

      "increased heart-rate"

      January 9, 2012 at 20:58 | Report abuse |
    • RenDoc

      Not that simple Frankster. The sustained release mechanism in patches is not nearly the same as the 'bolus' effect one gets with chain smoking or a wad of dip. You're very much overstating the risks as it applies to this topic.
      And obesity, Diabetes, high cholesterol, undertreated hypertension +/- genes cause far more heart attacks than smoking.

      January 10, 2012 at 02:47 | Report abuse |
    • Frangible

      Caffeine also does that, captain dramatic.

      January 10, 2012 at 10:37 | Report abuse |
  7. Boo

    Thanks for the meds Doc. The bad news is that I am now hopelessly addicted to nicotine. The good news is that I can remember where I put those darned cigarettes. kaff kaff

    January 9, 2012 at 20:58 | Report abuse | Reply
  8. Phil

    Dementia, Alzheimers and a severe lack of vitamin B-12 all look alike. 3 doctors failed to properly diagnose the condition with my mother...the fourth one actually found it was a B-12 deficiency...but it was years too late and the damage was already done.

    It may do something - it may not. Everyone is different chemically and will respond differently to treatment.

    January 9, 2012 at 21:07 | Report abuse | Reply
    • Elizabeth

      The problem is that the "average" amount of B-12 in the blood for the elderly is actually a deficiency. Look at the "average" B-12 expected for a person in their 20s or 30s, and use that as a measure. My daughter had an "average" B-12 for an 80 year old, around 200. She was given weekly B-12 shots, and she improved, including attention, concentration, memory, and mood. Many people do not have an "intrinsic factor" in their intestines that allow B-12 to absorb into the body, or else the liver breaks it down. These people cannot take a pill; they must get their B-12 in shot form. Also, many people do not eat enough B-12 in the first place. Few doctors take nutrition seriously, and because some people have overdosed on vitamins and minerals, they think all of them are not good. But B-12 is severely lacking in many people, as well as the rest of the B complex. Seaweed is the only vegetable that has B-12, but even meat sources cannot be absorbed by some. I hope that anybody reading this article does not rush out and buy nicotine sources, but I hope that everybody does some research into the B vitamin deficiencies and how dangerous they are.

      January 9, 2012 at 22:33 | Report abuse |
    • Alexa

      This isn't to suggest that the isoitpon is hopeless or that these products are without merit, but instead that caution should be exercised when gauging the allegedly never-ending supply of goodies promising you a simple way to quit smoking. The second 1/2 success comes from understanding that your body has become physically dependant on nicotine, and that all of the positive disposition in the world will not change that. This permits your body's nicotine reliance to adjust incrementally as you go, instead of being attacked with no holds barred nicotine deprivation.

      March 4, 2012 at 06:40 | Report abuse |
  9. medical student

    I think the real lesson from this is not that nicotine patches may be a treatment, but that dopamine pathways are likely far more significant in dementia and other neurological conditions than once believed.

    Parkinson's, Alzheimer's and other tauopathies, depression, autism, schizophrenia, bipolar disorder, the list goes on. All of these disorders, seemingly unrelated, exhibit tremendous co-morbidity and in relatively recent research it's been shown dopamine pathways may be involved in each. The future of psychiatric medicine may very well be tied to dopamine pathway targets in pharmaceuticals.

    January 9, 2012 at 21:09 | Report abuse | Reply
    • Angela

      Um, nicotine is an agonist at acetylcholine receptors (called nicotinic ACH receptors for this very reason). Are you thinking of indirect effects on dopamine.

      January 9, 2012 at 22:22 | Report abuse |
  10. R Burns

    Nicotine actually has a number of medicinal purposes, some approved by the FDA. Nicotine patches helped my ulcerative colitis/Crohn's disease tremendously, cutting down on bleeding episodes until I became allergic to the adhesive in the patch. Now if we could just tackle that problem. . .

    January 9, 2012 at 21:13 | Report abuse | Reply
    • Frangible

      Hydrocortisone creme and moving the patch around. Possibly a different brand with a different adhesive.

      January 10, 2012 at 10:52 | Report abuse |
  11. realist

    I smoke Newports faithfully and I forget things all the time.

    January 9, 2012 at 21:14 | Report abuse | Reply
    • Phil

      Holy %hit... I started on those over 24 years ago. Those were horrible.

      January 9, 2012 at 21:16 | Report abuse |
    • finman1960

      Too bad you can't forget that you smoke Newports faithfully.

      January 10, 2012 at 02:13 | Report abuse |
  12. Elizabeth

    This article makes me angry. My aunt used nicotine gum for many years. She developed lung cancer so-called, although the tumor may have started in the throat; and she died in pain, unable to eat. This sounds like an ad from a tobacco company. SHAME!!! Such ads are not allowed in the media; is this the new way to promote tobacco?

    January 9, 2012 at 22:23 | Report abuse | Reply
    • Frangible

      Because the nitrosamines which aren't in nicotine gun to begin with are absorbed directly into the lung from the oral mucosa. Congratulations, you have found a new biological transport mechanism in man. Be sure to submit your paper to Nature for peer review.

      January 10, 2012 at 10:41 | Report abuse |
  13. beancounter

    I had IBS most of my life with no answers from doctors. When I quit smoking I went into a full blown ulcerative colitis meltdown. Once I was diagnosed and given meds I healed and am on maintenance meds. I also started having depression and anxiety problems when I quit. I'm still happy I quit 11 years ago but I understand why so many can't or choose not to quit. Overall we know smoking is bad for you but for some there are "good" side effects.

    January 9, 2012 at 22:43 | Report abuse | Reply
  14. IQ

    Are they insane? My GOD it's the most addicting substance in the world. Someone, please shuts these loons down!

    January 9, 2012 at 23:35 | Report abuse | Reply
  15. moronparty

    is crack good too?

    January 9, 2012 at 23:51 | Report abuse | Reply
  16. johnnyfive

    Lets put a patch on liberals and see if the decline of America slows down.

    January 9, 2012 at 23:56 | Report abuse | Reply
    • M-Theory

      Conservatives sending jobs oversees and starting dumb wars has helped America greatly.

      January 10, 2012 at 01:07 | Report abuse |
  17. David Boone

    I have to disgree with IQ and moronparty. I thank it's a quality of life issue, I have Parkinsons (last 20 years) and I would have know problem taking an addicting drug if it could help me, in fact I do take pain meds. to ease the pain from 20 years of falling down things like my stairs and degentive disk problems my Dr. worked with me to get the right type and how much pain meds. I need to get through the day. I do not get a high from taking the addicting drugs and the only time I am not in pain is the 4 to 5 hours of sleep I get sleeping in my recliner. I would like you to think about ever wakeing hour you of ever day you have pain. I am 68 years old and thanks to my Dr. in Batesville, Arkansas I know longer thank about solving my pain problem another way.

    January 10, 2012 at 00:31 | Report abuse | Reply
  18. Lstrm

    "There has been pharmaceutical interest in using nicotine-like drugs for pain control and bowl disease"

    I'd hate to have that horrible bowl disease...

    January 10, 2012 at 00:55 | Report abuse | Reply
  19. M-Theory

    Strangely another little-known side effect of nicotine is as an oral disinfectant. When I quit smoking after 15 years, my gums and teeth had major issues. My periodontist told me that its common and that smoke and nicotine act like a bacterial disinfectant in the mouth. When you quit your mouth has little defenses and must ramp up it's enzyme count to get back to normal.

    January 10, 2012 at 01:03 | Report abuse | Reply
  20. bluemax77

    Well it would sure as hell calm you down about the diagnosis...

    January 10, 2012 at 01:36 | Report abuse | Reply
  21. Pw

    I quit smoking 3 months ago but have been using a nicorrette inhaler.

    January 10, 2012 at 02:04 | Report abuse | Reply
  22. Erik

    I've got ADD and I read about nicotine improving attention about 12 years ago. I started chewing nicotine gum to help me focus.

    ADD medications are almost exclusively focussed on adjusting dopamine levels. Nicotine affects acetylcholine pathways. I find them complementary and equally effective. The nicotine does something that cannot be compensated for by a higher dosage of a dopamine elevating product. Using them in combination I find is twice as effective as using either alone.

    So why aren't drug companies doing more to study nicotine? Must be the stigma associated with cigarettes. I don't smoke. Nicotine gum may increase the chance of certain form of cancers but it beats sitting there like a lump or being unable to sit still and settle down.

    Good to see that somebody is following up on that old research about the benefits of nicotine.

    If the tunnel vision that has limited ADD drugs to those that increase dopamine can be widened to include nicotine that will be a good thing. Probably not the end of it either- I highly doubt that attention and concentration can be reduced to the effects of two neurotransmitters.

    January 10, 2012 at 03:53 | Report abuse | Reply
    • Frangible

      Actually, nicotine increases dopamine levels in the brain as well, decreases DAT density, and has been found to be as equally efficacious as methylphenidate for the treatment of ADHD in children. Nicotine is also more expensive, has a much smaller therapeutic window, increased skin irritation in transdermal patch form, and no real oral bioavailability other than sublingual which leads to medication compliance problems even in adults.

      January 10, 2012 at 10:50 | Report abuse |
  23. allah

    allah states that smoking is good for you!
    allah is always right!
    allah is king!
    allah knows all!
    allah sucks off little boys!
    praise allah!

    January 10, 2012 at 04:09 | Report abuse | Reply
    • Maltese Falcon

      You are right. Amerika sucks.

      January 10, 2012 at 05:05 | Report abuse |
  24. portland tony

    I quit smoking to save my life......but what about my mind!

    January 10, 2012 at 07:14 | Report abuse | Reply
  25. JLC

    I was reading this article with great interest because of my own concern for developing Alzheimer's. I didn't seem to notice what level of nicotine patch was used. Did I just miss it? I believe there are three stages in the patch system.

    January 10, 2012 at 12:53 | Report abuse | Reply
  26. barb

    the side effects from most prescription drugs (that are not a cure for anything just a treatment) will kill you a lot quicker than cigarettes

    January 10, 2012 at 13:13 | Report abuse | Reply
  27. gager

    Another useless article. If the leader is a question it means the author doesn't know jack.

    January 10, 2012 at 15:25 | Report abuse | Reply
  28. Roy

    Medical Student, it is obvious that you know nothing about e-cigs, what plastic do you think is being heated? and there are hundreds of studies to show that they are safe, where are the studies to show that they are not safe? please point me towards a link, I would suggest you do some more research before you comment on something you know nothing about

    February 26, 2013 at 16:20 | Report abuse | Reply
  29. Barbara

    My 87 year old mother tried to quit smoking twice in the last 2 years. Both times she has become depressed, paranoid and confused; has memory issues (doesn't know what day it is, etc.); and has panic attacks. Within a day of her getting back on the cigarettes everything is back to normal.

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