When most individuals hear nicotine, they image stained lungs, cigarette advertisements, or sweet-flavored vapes. However nicotine isn’t tar, benzene, or formaldehyde. It’s a potent nicotinic acetylcholine receptor agonist with actual neurochemical results, and in fastidiously chosen sufferers, it could possibly assist. I’ve been utilizing nicotine gum and lozenges for years in sufferers with fatigue, gentle despair, and ADHD, not as a miracle treatment however as a focused cognitive and mood-enhancing instrument. It’s a stimulant, simply not the type that is available in a white powder or a pharmacy bottle.
The science was there lengthy earlier than the vape pens.
Nicotine stimulates nicotinic acetylcholine receptors, modulating dopamine, norepinephrine, and serotonin launch. That’s not advertising hype; it’s primary neuropharmacology.
- Consideration and vigilance: A number of lab research present improved response instances, working reminiscence, and sustained consideration in each people who smoke and non-smokers given low-dose nicotine.
- Temper: Nicotine acts as a gentle dopaminergic stimulant, growing dopamine within the mesolimbic reward system, which can assist sufferers with low temper or fatigue.
- ADHD and cognition: A number of managed trials have demonstrated short-term enchancment in consideration and govt perform with transdermal nicotine or gum in adults with ADHD.
Melancholy: We’ve really been right here earlier than
Earlier than SSRIs took over, nicotine was quietly studied as an augmentation technique in despair. Within the Nineties, small scientific trials utilizing transdermal nicotine patches in sufferers with refractory despair confirmed important temper enhancements inside days, not weeks. A 1995 Organic Psychiatry examine by Salin-Pascual and colleagues discovered that nicotine patch use led to speedy and measurable antidepressant results in treatment-resistant sufferers. Subsequent work in Psychopharmacology confirmed transient temper elevation, improved psychomotor velocity, and elevated alertness. These research had been small however compelling. Then SSRIs flooded the market, nicotine was culturally exiled, and the analysis door quietly closed.
The true drawback isn’t nicotine, it’s the supply system
Cigarettes and vapes are chemical clown automobiles: a whole bunch of poisons hitching a trip with a molecule that, by itself, has therapeutic potential. If caffeine solely got here via a grimy pipe, we’d demonize it too. Nicotine could be delivered cleanly and safely: gum, lozenges, and patches. Managed dose. No tar, no benzene, no combustion.
It’s not for everybody.
Nicotine is habit-forming and will by no means be prescribed casually. However to disregard its scientific potential as a result of it obtained caught within the incorrect supply system is unhealthy medication. We’ve seen this story earlier than with hashish, psychedelics, and beta blockers for efficiency anxiousness. It’s time to separate the molecule from the Marlboro and convey science, not stigma, to the dialog.
Larry Kaskel is an internist and “lipidologist in restoration” who has been working towards medication for greater than thirty-five years. He operates a concierge observe within the Chicago space and serves on the educating college on the Northwestern College Feinberg College of Medication. As well as, he’s affiliated with Northwestern Lake Forest Hospital.
Earlier than podcasts entered mainstream tradition, Dr. Kaskel hosted Lipid Luminations on ReachMD, the place he produced a library of greater than 4 hundred packages that includes main voices in cardiology, lipidology, and preventive medication.
He’s the creator of Dr. Kaskel’s Residing in Wellness, Quantity One: Let Meals Be Thy Medication, works that mix evidence-based medical observe with accessible methods for enhancing healthspan. His present tasks deal with reevaluating the ldl cholesterol speculation and investigating the infectious origins of atherosclerosis. Extra data is out there at larrykaskel.com.
