Nicotine Patch Shows Promise in Treating Late-Life Depression
Source: Vanderbilt University
Summary: A pilot study of treating late-life depression in nonsmokers with transdermal nicotine (nicotine patch) has yielded some promising results, but the study’s author cautions that more study is needed.
Late-life depression, depression that occurs in adults 60 years or older is characterized by poor response to antidepressant medications and often memory issues. About half of those treated for late-life depression fail to respond to initial treatments. Although there have been no published studies in geriatric populations, several small trials in non–smokers with midlife major depressive disorder report that nicotine reduces depressive symptom severity. Depression, especially in older adults, can be characterized by memory problems, where their memory isn’t as good as people the same age and the same education who are not depressed. When depression is treated their memory may get better, but it often doesn’t improve to where it should be. A Vanderbilt University Medical Center pilot study of treating late-life depression in nonsmokers with transdermal nicotine (nicotine patch) has yielded some promising results, but the study’s author cautions that more study is needed. The study findings were published in The Journal of Clinical Psychiatry.
The 12-week study was conducted between November 2015 and August 2017 and looked at 15 people, 60 and older, suffering from a major depressive disorder. The average age was 65. All participants received the nicotine patch. There were no placebo patches used in the study. Some study participants were already on antidepressant medications, but not doing well. Some were not currently taking antidepressants. The nicotine patch was added to what they were already taking or used alone if they were not taking an antidepressant medication. The patches were applied daily and titrated in a rigid dose escalation strategy to a maximum dose of 21.0 mg. The primary mood outcome was measured every three weeks. The participants also had their cognitive outcome measured with a neuropsychological test battery. The study measured remission the state where the depression is almost gone and the person is functioning well. Fifty percent of the participants hit remission, and more than 80% had some good clinical response, even if they didn’t reach remission.
Prof. Warren Taylor said, “This could be a medication option for those who don’t respond well to the first line of antidepressant medications” and further added, “It might be an important treatment option when combined with other medications. But there’s a lot of work to be done before we get there.”
More Information: Jason A. Gandelman et al, “Transdermal Nicotine for the Treatment of Mood and Cognitive Symptoms in Nonsmokers With Late-Life Depression”, The Journal of Clinical Psychiatry (2018). DOI: 10.4088/JCP.18m12137