Paul A. Newhouse, MD
Paul A. Newhouse, MD, director, Center for Cognitive Medicine, and professor of psychiatry and Jim Turner Professor of Cognitive Disorders, department of psychiatry, Vanderbilt University, both in Nashville.
When you think about nicotine, it’s likely that negative words like “addiction” and “cigarettes” come to mind.
But what if I were to tell you that there’s a new use for nicotine that actually may be beneficial to the brain…and that it might not be so dangerous?
A new study shows that the substance may help improve memory in certain people. So I did some digging to find out what all the buzz was about…
There are some people who have severe memory loss, such as people suffering from Alzheimer’s or other forms of dementia, but far more people experience a less severe form of memory loss called mild cognitive impairment (MCI).
MCI is more than just everyday forgetfulness—it’s the stage between normal forgetfulness and the onset of dementia (though not everyone with MCI will develop dementia). MCI might include, for example, having trouble with everyday problem solving (such as balancing a checkbook), forgetting recent conversations or occasionally struggling with hobbies you once enjoyed because you can’t remember the steps.
There are no drugs that are proven to help MCI, but a researcher at Vanderbilt University’s Center for Cognitive Medicine in Nashville recently made an interesting find: The nicotine in the patches that are currently used to help people quit smoking seem to help improve memory in people with MCI.
The researchers enrolled 67 seniors (average age 76), all of whom were current nonsmokers with MCI. They were given a series of memory and cognitive tests. Then half of them started wearing nicotine patches (one 15-milligram patch for 16 hours each day) for six months, while the other half wore placebo patches. The study was “double blind,” so neither the participants nor the researchers working directly with them knew which patches contained nicotine.
When the subjects were given memory tests again after six months, the patients receiving nicotine showed improvements in memory on several tests, while the placebo group did not show improvements on any tests (and sometimes showed declines). For example, on one particular long-term memory test, the nicotine-patch group improved by 46%, while the placebo group declined by 26%.
The researchers aren’t sure whether the memory improvements seen in the nicotine group lasted longer than six months—and if so, for how long—because the subjects weren’t followed for more than six months, but future studies will attempt to answer that question. The study was published in the January 2012 issue of Neurology. To find out why nicotine may have had this effect, I called Paul A. Newhouse, MD, director of the center and the lead author.
Dr. Newhouse noted that nicotine stimulates parts of the brain that act as receptors of acetylcholine, a neurotransmitter that is linked to attention, which is important for learning and memory. In Alzheimer’s patients and in those with advanced dementia, there tend to be fewer receptors, but in patients with MCI there are more, so the researchers thought it might work…and it appears to.
Now what are the risks, you may be wondering? From what Dr. Newhouse found in this study (and from what other studies about the effects of the patches have shown), there aren’t many. None of the participants developed an addiction to nicotine, including those who were former smokers, although it is possible that long-term use of nicotine patches could lead to addiction. A few had mild nausea and dizziness at first—much like you would when smoking for the first time. The only noticeable side effect was weight loss, which isn’t a surprise as nicotine is an appetite suppressant. It’s also possible that users could require higher and higher doses of the nicotine for it to continue to be effective, which would increase risk for side effects. The 15-mg dosage might seem high (a cigarette contains roughly 1 mg of nicotine), but with the patch, the nicotine is delivered at a slow, steady rate throughout the day, and lesser amounts are absorbed through the skin than through smoking. And there’s no known cancer risk with the patches.
Nicotine patches are available over-the-counter, but Dr. Newhouse stresses that you shouldn’t start using them just because you think that you’re forgetful. Why? For one, larger studies need to be done to prove whether the nicotine is as helpful as this initial study makes it seem—Dr. Newhouse calls the early results “encouraging,” but that doesn’t make them definitive. Two, if you aren’t suffering from MCI, putting on a nicotine patch can actually lead to too much stimulation in your brain and make it hard to concentrate. And three, you shouldn’t self-diagnose your cognitive function—because you might be dealing with something more serious than you realize. “Consult a physician or get evaluated at a memory clinic before trying a nicotine patch or any form of treatment,” said Dr. Newhouse. In the end, this will be interesting research to watch. It might just be that, though smoking is bad for you, a nicotine patch could do some good.