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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 72. This is the beginning of the thread.
Posted by jedi on September 16, 2006, at 2:22:02
Hi Guys,
I've noticed that a large number of people with chronic depression are smokers. Nicotine is a uniquely addicting drug that stimulates and relaxes people. Of course the deadly side effects of smoking make it not a very wise choice as a treatment for depression. Here is a study that suggests that nicotine will help even non-smokers with the symptoms of depression. Please don't use this as an excuse to start smoking. I'm just thinking that maybe some of the effects of nicotine can be isolated to create a better treatment for some depressions.
Jedi
Nicotine may help reduce depression in non-smokers:
Study By - IANSFull Story can be found at http://www.dnaindia.com/report.asp?NewsID=1052717&CatID=5
NEW YORK: Nicotine may help reduce depression in non-smokers, says a new study, though scientists caution that people with depression should not attempt to smoke or even start using a nicotine patch.
Researchers led by Joseph McClernon at Duke University Medical Center recruited 11 people who did not smoke but who were experiencing symptoms of depression, according to a university release.
Participants were randomly assigned to wear either a nicotine patch or a placebo patch that did not contain any nicotine and measured depression symptoms among them.
The researchers found that participants who wore the nicotine patch for at least eight days experienced a significant decline in their depression assessment rating scores.
"The hope is that our research on nicotine will spur the development of new treatments for depression, which is a huge public health problem," said McClernon.
Despite the positive effects of nicotine discovered in their study, the researchers emphasised that it is not currently appropriate for treatment of any medical disorder outside of nicotine dependence.
"I certainly recommend that people don't smoke," said Edward Levin, another researcher of the study. "If you do smoke, quit."
The researchers stressed that people with depression should not start smoking or even start using a nicotine patch.
They said smoking remains the No. 1 preventable cause of death and disability in the US, and that the addictive hazards of tobacco far outweigh the potential benefits of nicotine in depression.
But the finding suggests that it may be possible to manipulate nicotine's effects to safely reap its potential medical benefits, according to the researchers.
As an example of the drug's potential, they said, pharmaceutical companies are already developing compounds for treating other brain disorders by mimicking the beneficial properties of nicotine while avoiding its addictive nature.
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Posted by dbc on September 16, 2006, at 4:08:27
In reply to Nicotine and Depression, posted by jedi on September 16, 2006, at 2:22:02
I seem to remember some comparison to emsams action on dopamine to how nicotine acts in a smokers brain. So this is entirely possible.
Posted by dondon on September 16, 2006, at 5:38:45
In reply to Re: Nicotine and Depression, posted by dbc on September 16, 2006, at 4:08:27
when i am depressed and I smoke I get more depressed.
Posted by laima on September 16, 2006, at 7:38:23
In reply to Nicotine and Depression, posted by jedi on September 16, 2006, at 2:22:02
Very interesting. I note though, that depression is also a "very serious health problem" and and full of risks...including death.
I hope they do manage to manipulate something out of it.
Posted by linkadge on September 16, 2006, at 7:42:30
In reply to Re: Nicotine and Depression, posted by dondon on September 16, 2006, at 5:38:45
Nicotine only has limited reinforcement properties in animals. Animals do not self inject nicotine like they do cocain or heroin.
I don't think the comparisons between nicotine and heroin are acurate at all. I think that statistically it may be as hard to quit, but that may not be due to the drug at all, but rather issues of acessability, etc.
I've been on and off nicotine gum so many times, but I wouldn't even begin to say that I could compare that to heroin withdrawl. Nicotine withdrawl was not hard for me at all.
That being said, I found it did have antidepressant properties. It also reduced my anxiety tremendously. After chewing it, it felt like I just took a valium. I felt very heavy, and sedated, and just wanted to sit down and relax.
Nicotine supposedly works as a 5-ht1a agonist like buspar.
There is some issue about nicotine potentially affecting the heart (angiogenesis). While other consituents in tobacco are much more toxic, I'd like to know the full extent of nicotine's safety.
Linkadge
Posted by SLS on September 16, 2006, at 8:44:43
In reply to Nicotine and Depression, posted by jedi on September 16, 2006, at 2:22:02
It is an interesting study.
> "The researchers found that participants who wore the nicotine patch for at least eight days experienced a significant decline in their depression assessment rating scores."
Remember, though, it has not demonstrated how chronic treatement would affect these people. 8 days is not long enough to allow many types of receptors to reregulate themselves.
The URL provided no longer works, so we don't really know the length of time the study ran for.
- Scott
Posted by willyee on September 16, 2006, at 11:20:32
In reply to Nicotine and Depression, posted by jedi on September 16, 2006, at 2:22:02
I workout,have since im 16.Cardio wise im probuably in enough shape to claim average,however i lift weights more so.
That said id obviously want to stop smoking,however the most i attempt now is cutbacks,even as a hypocrite i still fear stopping,i am postive id have a much worsened depressive state.
My brother just quit,and for the first time he called me and told me he understood what anxiety and depression must feel like,on the phone he described it to me and for the first time it sounded like he had a clue.
As far as the studies go,i mentioned before you can find so much on the net,so id recomend taking in everything with some salt and never forgetting to use actual life experieaces as a extremly crucial part,ive seen almost everthing ive read contradicted including smoking and caffiene being both harmful as well as positive for depression,i think we just dont know,and are judging all these end results we find from person to person as a main cause,when in fact as LOL I READ ONCE the main cause of depression is believed to be deep in a part of the brain we have not done much studying on yet,and that it lies similiar to parts of the brain responsable for laughter.
Posted by linkadge on September 16, 2006, at 13:09:24
In reply to Re: Nicotine and Depression » jedi, posted by willyee on September 16, 2006, at 11:20:32
I will look for the study I read on the effects of nicotine on depressive behavior in the flinders sensitive mouse line. The study said that nicotine had a profound (positive) impact on their mood.
Linkadge
Posted by linkadge on September 16, 2006, at 13:13:33
In reply to Re: Nicotine and Depression » jedi, posted by willyee on September 16, 2006, at 11:20:32
http://biopsychiatry.com/nicotine.htm
It was a short study, but I think it confirms what many self medicaters know.
What I really find funny/ironic, is that you can go to a doctor to get electroshocked for your depression, but yet they caution against the use of nicotine because the "long term effects are not known". What a bunch of.....
Linkadge
Posted by SLS on September 16, 2006, at 22:46:48
In reply to Re: Nicotine and Depression, posted by linkadge on September 16, 2006, at 13:13:33
> http://biopsychiatry.com/nicotine.htm
This study is interesting. I wonder if the rats had nicotine in their bloodstreams when they were tested.
> It was a short study, but I think it confirms what many self medicaters know.
>
> What I really find funny/ironic, is that you can go to a doctor to get electroshocked for your depression, but yet they caution against the use of nicotine because the "long term effects are not known". What a bunch of.....Nicotine provides mild anxiolytic, reward, and euphoriant effects, but it is not a potent antidepressant. If it were, we wouldn't see so many depressed people smoking cigarettes. It would, of course, be the best kept secret in psychiatry.
People who are depressed choose many different drugs and behaviors to self-medicate. This does not make these things antidepressants.
Nicotine is not an antidepressant.
- Scott
Posted by jedi on September 17, 2006, at 0:08:04
In reply to Re: Nicotine and Depression, posted by SLS on September 16, 2006, at 22:46:48
...
> Nicotine provides mild anxiolytic, reward, and euphoriant effects, but it is not a potent antidepressant. If it were, we wouldn't see so many depressed people smoking cigarettes. It would, of course, be the best kept secret in psychiatry.
>
> People who are depressed choose many different drugs and behaviors to self-medicate. This does not make these things antidepressants.
>
> Nicotine is not an antidepressant.
Scott,
Your logical thinking on this makes perfect sense. I guess I won't rush out to buy nicotine gum.
Jedi
Posted by linkadge on September 17, 2006, at 9:48:32
In reply to Re: Nicotine and Depression, posted by SLS on September 16, 2006, at 22:46:48
>Nicotine provides mild anxiolytic, reward, and >euphoriant effects, but it is not a potent >antidepressant.
That may not be true. When you have a substance like nicotine, the assumption is that it can have no theraputic effect because it has some addictive potential. To be honest, it hasn't been studied enough in such applications. As you are well aware, there are many products whoose antidepressant properties have been denounced (ie SJW) probably based on other factors. For instance, a study that prooved nicotine to be an antidepressant could encourage people to continue smoking.
We base the antidepressant effect of the TCA's, SSRI's, MAOI's, valdoxan, remeron etc on their efficacy in the flinders sensitive line, so why reject such a study that identifies nicotine in such a way?
>If it were, we wouldn't see so many depressed >people smoking cigarettes. It would, of course, >be the best kept secret in psychiatry.
Why. Thats like saying that antidperessants don't work, because we see a lot of depressed people taking them. There are plenty of non depressed people who smoke, who can become very depressed when they quit. It is possable that nicotine has been maintaining a state of euthemia in an otherwise depressive individual. Depressed people who smoke could perhaps be much worse without smoking. Its not that its a secret, it just hasn't been directly studied very much.>People who are depressed choose many different >drugs and behaviors to self-medicate. This does >not make these things antidepressants.
This is true, but allong the same lines, it does not mean they are *not* antidepressants.
>Nicotine is not an antidepressant.
Well thats the debate. Clearly, we know that how one agent affects a person is undrelated to how the agent affects another person. The definition of an antidepressant is simply an agent that can provide sustained relief of depressive symptoms.
I personally noticed a sustained improvement in a few symtpoms of depression while I was using a fixed dose of nicotine to counteract SSRI side effects. (3-4 months 4mg/day) The main improvements were reduction of feelings of guilt, sustained reduction in anhedonia, improved concentration, destinct psychosocial imrprovment (I was hanging out with friends again, I've slipped back to hiding in my apartment all day),
significantly reduced physical anxiety, improved
sleep, and improved feelings of worthlessness.
It was destinct to nicotine, I did not have any such AD effects on caffiene, ritaline, dexedrine etc.
Linkadge
Posted by linkadge on September 17, 2006, at 10:14:15
In reply to Re: Nicotine and Depression, posted by linkadge on September 17, 2006, at 9:48:32
I mean honestly, if you saw us group of depressed people sitting around on a porch step, popping our effexors, and our prozacs, you'd start to think that these agents were not antidepressants either :)
Here is a very instersting study that states that the Nicotine Actycholine receptors are respondiable for the antidepressant effects on the TCA drug amitryptaline. It states that mice lacking such receptors are resistant to its effects. The flinders sensitive line seem to show imballances in serotonin/acetycholine/dopamine. Nicotine administration itself produces a functional inhibition of these receptors.http://www.yaledailynews.com/Article.aspx?ArticleID=26692
Another study from:http://www.lorenbennett.org/nsmok.htm#patch
Transdermal nicotine patch lessens depression
The role of repeated nicotine administration on sleep and major depression was studied in tests. Twelve nonsmoking volunteers: six major depressed patients and six normal patients. All subjects underwent t: acclimatization, control night, four nicotine nights (transdermal patches) and one withdrawal night. Nicotine increased REM sleep time in both groups and an average reduction the seriousness of depression of 43.9% in the depressed patients. These findings suggest that nicotine receptor activation may be important in major depression, and shows that nicotine patches may be useful in the treatment of depression.
Some others:
http://www.jointogether.org/news/research/summaries/2006/nonsmokers-depression-lifted.html
http://www.sciencedaily.com/releases/2002/12/021211083430.htm
http://www.sciencenews.org/articles/20020511/note17ref.asp
Linkadge
Posted by SLS on September 17, 2006, at 10:46:51
In reply to Re: Nicotine and Depression, posted by linkadge on September 17, 2006, at 9:48:32
It did for you what I said it would. You did those things that those effects would promote. You are no longer taking it. It did not work. It is not an antidepressant.
- Scott
Posted by SLS on September 17, 2006, at 11:15:39
In reply to Re: Nicotine and Depression, posted by linkadge on September 17, 2006, at 10:14:15
The mistake that I see often made in the interpretation of such studies is that they are demonstrating that a system must be intact for a drug to work. It does not demonstrate that that system is the site of action of the drug. That was the mistake made with Provigil (modafinil) and NE alpha-1 receptors.
- Scott
Posted by linkadge on September 17, 2006, at 12:29:27
In reply to Re: Nicotine and Depression, posted by SLS on September 17, 2006, at 10:46:51
>It did for you what I said it would. You did >those things that those effects would promote. >You are no longer taking it. It did not work. It >is not an antidepressant.
No, that is absolutely not true. For the time I took nicotine gum, there was no significant tollerance to its effects. I was literally doing better for the whole time. I didn't stop because it didn't work, I stopped because I read that it might affect the cardiac muscle negitively.
Its the same with clomipramine. The drug worked, but I stopped because I read it was genotoxic.
Thats the truth.Linkadge
Posted by linkadge on September 17, 2006, at 12:41:20
In reply to Re: Nicotine and Depression, posted by SLS on September 17, 2006, at 11:15:39
I agree, its not conlcusive, but the research is suggestive.
The same thing goes with any research though.
Ie. Neurogenesis theory sounds good, based on the finding that blocking the formation of new brain cells blocks the AD effect, but its not conlcusive.We simply need to see more long term double blind studies comparing nicotine to placebo in the treatment of major depression. There aren't a whole lot, but they are what would make or break the case.
You can say, well its not an antidepressant its just a euphoriant etc. etc. But there are really no rules. Just because a substance causes mild euphoria doesn't mean it is devoid of other effects which could be at the heart of affective disorders. Caffiene causes some euphoria, but otoh we know that coffee statiscially reduces the risk of suicide. Thats signficant.
Its easy to just form black and white opinions about certain substances, and then lump them into good and bad boxes.
We put marajuanna into the bad box because it causes a little euphoria, but again, that does not mean it is devoid of theraputic effect. Ie HPA axis reulation, promotion of neurogenes etc etc.
Linkadge
Posted by SLS on September 17, 2006, at 14:26:45
In reply to Re: Nicotine and Depression, posted by linkadge on September 17, 2006, at 12:29:27
> >It did for you what I said it would. You did >those things that those effects would promote. >You are no longer taking it. It did not work. It >is not an antidepressant.
>
> No, that is absolutely not true. For the time I took nicotine gum, there was no significant tollerance to its effects. I was literally doing better for the whole time. I didn't stop because it didn't work, I stopped because I read that it might affect the cardiac muscle negitively.
>
> Its the same with clomipramine. The drug worked, but I stopped because I read it was genotoxic.
> Thats the truth.Well, then, I must apologize for jumping to conclusions. I am sorry.
I would reevaluate carefully the material you have read regarding clomipramine and genotoxicity. Your life may depend on it. If you found it online, maybe you could show it to us to take a look at. Fruit flies lie sometimes.
- Scott
Posted by saturn on September 17, 2006, at 20:29:08
In reply to Nicotine and Depression, posted by jedi on September 16, 2006, at 2:22:02
I can still recall my first cigarette buzz back in high school-- almost orgasmic.
Posted by linkadge on September 19, 2006, at 11:47:34
In reply to Re: Nicotine and Depression, posted by saturn on September 17, 2006, at 20:29:08
I never really got a buzz from nicotine. It felt like a sedative.
Linkadge
Posted by linkadge on September 19, 2006, at 11:53:24
In reply to Re: Nicotine and Depression, posted by saturn on September 17, 2006, at 20:29:08
The clomipramine doesn't really matter. There are too many other negative health consequences associated with the TCA class. Its too risky.
Three members of our family had TCA associated cardiac events.Clomipramine was giving me some form of seizure. Simple partial (?) Not sure what the doctor called it. No loss of contiousness, but muscle stuff associated with strange experiences / abdominal stuff.
Couldn't pee either.
Can't really remember, much of being on the drug was a haze.
Linkadge
Posted by Questionmark on September 24, 2006, at 18:08:34
In reply to Re: Nicotine and Depression, posted by saturn on September 17, 2006, at 20:29:08
> I can still recall my first cigarette buzz back in high school-- almost orgasmic.
Yeah, back in high school when i only rarely had a cigarrette, the buzz would be so wonderful: a strong, beautiful euphoria i fell in love with. I miss it.By the way Scott/SLS and Linkadge you guys made some really good points in this thread.
Posted by MrBrice on October 2, 2006, at 5:49:25
In reply to Re: Nicotine and Depression, posted by Questionmark on September 24, 2006, at 18:08:34
Nicotine DOES work, when i take 2-3 nicotine sublilingual tablets (6mg's), i actually feel the dopamine creeping in and the anxiety going away.
makes me long for an maoi.
Posted by SLS on October 2, 2006, at 5:55:58
In reply to Re: Nicotine and Depression, posted by MrBrice on October 2, 2006, at 5:49:25
> Nicotine DOES work, when i take 2-3 nicotine sublilingual tablets (6mg's), i actually feel the dopamine creeping in and the anxiety going away.
>
> makes me long for an maoi.
Why would you long for an MAOI if nicotine works for you?What is inadequate about nicotine?
- Scott
Posted by SLS on October 2, 2006, at 6:17:59
In reply to Re: Nicotine and Depression » MrBrice, posted by SLS on October 2, 2006, at 5:55:58
> > Nicotine DOES work, when i take 2-3 nicotine sublilingual tablets (6mg's), i actually feel the dopamine creeping in and the anxiety going away.
> >
> > makes me long for an maoi.
>
>
> Why would you long for an MAOI if nicotine works for you?
>
> What is inadequate about nicotine?
What is your total daily dosage?How many times a day do you take it?
How long have you been taking it at a consistent dosage every day?
- Scott
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