Thursday, August 13, 2009

Nicotine patch, the human body, sex drive and ADHD

notes from an email from a doctor in the USA in response to our telling him we give our son a nicotine patch to treat ADHD (recommended to us by an ADHD/Autism expert in Stavanger, Norway):
There are 3 sets of nerves-------Somatic--largest---Motor nerves to muscle.

-------------Sympathetic----mediated by Norepinephrine (a close relative of Adrenaline)--stimulates heart, blood vessels, gut, etc.

-------------Parasympathetic---mediated by Acetylcholine (AC)---controls automatic body functions---breathing, heartbeat, peristalsis, etc. When stimulated, AC is released at the nerve Junctions (Most nerves have 2 or 3 segments, rather than 1 long nerve) & at the nerve endings, where it produces a response in the end-organ. There are receptors in many organs in the body & also the brain, which then respond to the AC that is released.(The AC is then quickly inactivated by an Enzyme---Chlonesterase, so the reaction does not continue unless further activated from the Brain. The Receptors are of two kinds, Nicotinic (react as if given Nicotine) & Muscarinic (react as if eating certain mushrooms), & the response depends on which receptors are more prevalent or are stimulated more (not all respond in the same way).

I have found a good listing of the Nicotinic & Muscarinic effects in the Brain, but unfortunately the effects are all listed together, so I don't know for sure which is which, but since [your child] has been diagnosed with ADHD, then I think the Muscarinic effects might be some of the following------difficulty concentrating, restlessness, anxiety, or emotional lability. In any case, the Muscarinic effects could be counteracted by Nicotinic effects, which actual Nicotine could provide. Of course in the USA that is too easy, so there are drugs which cost an arm & a leg to treat Children or Adults with ADHD.

i personally use the nicotine patch to lower my sex drive and it seems to work great. i use half of a 7mg patch. my weight is about 77kg, if that has any value. i found out that the patch can reduce sex drive only by accident, because my wife told me to wear the patch myself to see how it affected my body since we were going to give it to our son.

in the meantime i have found this article about nicotine being bad for the arteries:
Your Sex Drive: 6 Essentials | Anti-Aging | Reader's Digest
where they say among other things:
Nicotine, on the other hand, is an enemy of the arteries. Nicotine not only promotes the formation of atherosclerotic plaque in the penile blood vessels but also constricts them.

i wrote this doctor in the USA to ask his opinion and this is his reply:
Though I have not treated Autism, or prescribed the Nicotine Patch, I can give my thoughts from reading of Medical Articles.

Yes, long term, heavy use could lead to Arterial damage in any arteries:, penile, renal, coronary, carotids. This applies mostly to heavy smokers for 20-plus years. With [your child], the considerations are these:
1): If there is an imbalance in body Chemistry, the bad side effects are less likely to occur. The difficulty here is knowing how much to give. The smallest effective dose is the goal & it may be acceptable from time to time to reduce the dose to see if symptoms recur, because over time he may need less.
2): As stated, use the smallest effective dose & not for more years than necessary. Some effects of overdosage or toxicity are: dizziness, falling, sleeping problems, vivid dreams, rapid or irregular heartbeat, or diarrhea.

Since your doctor is a specialist in Autism, my advice would be to follow along with him. Nicotine does not always work, but the same is true for the high-powered new drugs on the market, & they also have side effects. So if the Nicotine is working, I would say stay with it for a long period, but at a minimum dose.

UPDATE: i just read up on atherosclerosis

Cigarette habituation: A major and modifiable risk factor for atherosclerosis and is associated with an increased relative risk of dying from vascular disease. The mechanisms are complex and likely multifactorial and result in endothelial dysfunction and a relatively hypercoagulable state. This increased relative risk rapidly and significantly is reduced with smoking cessation. The relative risk is reduced to the extent that the incidence of coronary heart disease in people who have recently quit smoking is similar to that of people who have not smoked for at least 2 years. It should also be mentioned that air polution in recent years has gained increasing recognition as a contributing modifiable risk factor in the urban communities. The mechanism is thought to be through the participation of combusion derived nanoparticles acting through proinflamatory or alternatively direct cardiac toxic pathways.

it seems to me that this is talking about physical smoking of cigarettes, not the nicotine drug itself, since they bring up air pollution.

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