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

Published online by Cambridge University Press:  16 April 2020

Anne L. Howson ,
Sue Batth ,
Vadim Ilivitsky ,
Armand Boisjoli ,
Martine Jaworski ,
Colleen Mahoney  and
Verner J. Knott
Anne L. Howson
Affiliation:
Adult Metabolic Disease Clinic, Vancouver General Hospital, Vancouver Coastal Health Authority, Vancouver, BC, Canada
Sue Batth
Affiliation:
Department of Psychiatry, Royal Ottawa Hospital and Institute of Mental Health Research, University of Ottawa, 1145 Carling Avenue, Ottawa, Ont., CanadaK1A 7K4
Vadim Ilivitsky
Affiliation:
Department of Psychiatry, Royal Ottawa Hospital and Institute of Mental Health Research, University of Ottawa, 1145 Carling Avenue, Ottawa, Ont., CanadaK1A 7K4
Armand Boisjoli
Affiliation:
Tourette Syndrome Clinic, Ottawa Hospital, Ottawa, Ont., Canada
Martine Jaworski
Affiliation:
Tourette Syndrome Clinic, Ottawa Hospital, Ottawa, Ont., Canada
Colleen Mahoney
Affiliation:
Department of Psychiatry, Royal Ottawa Hospital and Institute of Mental Health Research, University of Ottawa, 1145 Carling Avenue, Ottawa, Ont., CanadaK1A 7K4
Verner J. Knott*
Affiliation:
Department of Psychiatry, Royal Ottawa Hospital and Institute of Mental Health Research, University of Ottawa, 1145 Carling Avenue, Ottawa, Ont., CanadaK1A 7K4
*
*Corresponding author. E-mail address: vknott@rohcg.on.ca (V.J. Knott).
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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 potentials, 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.

Keywords

NicotineTourette’s syndromeTicsAttentionPerformanceEvent-related potentials
Type
Original article
Information
European Psychiatry , Volume 19 , Issue 2 , April 2004 , pp. 102 - 112
Copyright
Copyright © 2004 European Psychiatric Association

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