Changes in compulsion and anxiety symptoms with nicotine transdermal patches in non-smoking obsessive-compulsive disorder patients.

Objective: Some of the obsessive-compulsive disorder (OCD) symptoms can be elicited in rats by the administration of quinpirole (D2/D3 dopaminergic agonist). Nicotine administration blocked some aspect of checking behavior in that model. The main goal of this study was to determine if the clinical manifestations of OCD non smoking patients change with the administration of transdermal nicotine patches.

Material And Methods: Eleven patients were studied (6 female and 5 males), average age 29.7 +/- 5.5 years. All of them were OCD according to DSM-IV criteria. Clinical scorings were done with Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). Nicotine (17.5 mg/day) or placebo transdermal patches were randomly administered for five continuous days.

Results: Nicotine administration reduced the total Y-BOCS and the compulsive score of that scale, but did not reduce obsessions. Also anxiety was reduced as was shown by the BAI scores, when patients were on nicotine patches, no changes were observed in BDI.

Conclusions: The present results replicated the animal findings about reduction in compulsive behavior after nicotine administration. Also suggest that nicotine depending on the dysfunction of the different neurotransmitter systems may produce different behavior or cognitive effects, also that even nicotine showed some beneficial effect in OCD patients, the low rate of nicotine smoking in this type of patients, may show other mechanisms than may protect to smoke in some psychiatric patients.