Use this section to discuss your experiences with prescription drugs, iron injections, and other medical interventions that involve the introduction of a drug or medicine into the body. Discuss side effects, successes, failures, published research, information about drug trials, and information about new medications being developed.

Important: Posts and information in this section are based on personal experiences and recommendations; they should not be considered a substitute for the advice of a healthcare provider.
Posts: 519
Joined: Wed Mar 13, 2013 12:53 pm
Location: Berlin / Germany


Postby QyX » Thu Sep 20, 2018 8:15 am

Inspired by one article in this forum where a member did experiment with nicotine as a possible treatment options for RLS I yesterday started my own research. First, here is the link to the original article in the board: viewtopic.php?f=20&t=10275

So after I did some research (basically only reading the wikipedia article and combining it with my own nicotine experience) I want to present first results but before I say anything more, here is a warning:

Nicotine is highly addictive. An average cigarette yields about 2 mg of absorbed nicotine; in lesser doses of that order, the substance acts as a stimulant in mammals, while high amounts (50–100 mg) can be harmful. Nicotine addiction and dependence involves drug-reinforced behavior, compulsive use, relapse after abstinence, physical dependence, psychological dependence, and drug tolerance.

Pls be very careful if you consider to experiment with nicotine. Also I strongly advise against using nicotine in the form of tobacco / cigarettes. Tobacco has many many other psychoactive ingredients which make nicotine way more addictive than when it is consumed only by itself.

Beyond addiction, both short and long-term nicotine exposure have not been established as dangerous to adults, except among certain vulnerable groups.

Since opioids and especially Lyrica can be highly addictive, too, I must say I don't see much of a difference between using nicotine or opioids. Having said that, I don't believe nicotine to be a general treatment option for RLS like opioids, dopamine-agonists or antiepileptics.

However, the complex pharmacodynamic effects of nicotine might, in some cases, very helpful with initiating and maintaining sleep, especially when you suffer from something I would call "hyperalertness" during night, having frequent awakenings (more than 5) or you simply can't fall asleep again because you feel some weird stimulant effect going on in your brain, even though you feel tired, even exhausted but you still can't sleep with your other RLS symptoms being mostly fine.

To me it seems nicotine is only MAYBE a possible treatment options for secondary RLS symptoms when opioids or antiepileptics are great in managing your movement and pain related issues but you still can't fall asleep because you are awake, even you were working doing stuff all day long.

Okay, so here are some more quotes from wikipedia:

When a cigarette is smoked, nicotine-rich blood passes from the lungs to the brain within seven seconds and immediately stimulates nicotinic acetylcholine receptors; this indirectly promotes the release of many chemical messengers such as acetylcholine, norepinephrine, epinephrine, arginine vasopressin, serotonin, dopamine, and beta-endorphin in parts of the brain.

Nicotine also extends the duration of positive effects of dopamine and increases the sensitivity of the brain's reward system to rewarding stimuli.
In this context, pls consider how especially opioids and dopamine-agonists affect the brain!!!

While no epidemiological evidence directly supports the notion that nicotine acts as a carcinogen in the formation of human cancer, research has identified nicotine's indirect involvement in cancer formation in animal models and cell cultures

So basically the current available evidence can't prove nicotine is directly linked to cancer, it is still not a 100% safe product. Of course the overall dose and exposure over the years matters a lot but nicotine itself is far more save than tobacco. Having said that, experimenting is probably only for those who are currently smokers anyway or are fully aware of the potential risks of experimenting with nicotine. They also should do their own research and nicotine is probably best used as a experimental drug for patients like me who suffer from symptoms who seem otherwise untreatable.

This nicotine-induced dopamine release occurs at least partially through activation of the cholinergic–dopaminergic reward link in the ventral tegmental area. Nicotine also appears to induce the release of endogenous opioids that activate opioid pathways in the reward system, since naltrexone – an opioid receptor antagonist – blocks nicotine self-administration.
To me it is unclear what that fully means in terms of modulating RLS symptoms, however it shows that nicotine messes with the brain in the same areas as opioids do.

HOWEVER: it seems like that nicotine can worsen RLS symptoms during the day and improve them at night. That is something the original poster pointed out in his first posts. I had a phase where I relapsed into smoking tobacco again and I remember very well that I to increase my opioid dosage to manage my RLS symptoms. However: tobacco has many other active ingredients who knows how they messed with my brain.

But it also obvious for me that nicotine has different effects at night then during day. I noticed this so often in the past but never was able to make the connection until I finally saw this post in another subsection in the forum. Also I remember very well that I often tried to stimulate myself on parties with nicotine when I got tired late at night, but only the opposite happened, the more I smoked, the more tired I became. Back then I contributed those effects mainly to the alcohol but now I understand the alcohol only played a minor role.

When I'm at home for christmas or important birthday parties, I often relapse into using cigarettes again. And the weird thing for me always was: I always slept great when I am at home. And I just thought this is because my RLS is treated so well with opioids and antiepileptics. When I woke up at night, I went to go for a smoke and then back to bed. I thought I was able to go back to sleep quickly because of the great treatment, but the more I investigate it, the more I think it is not despite the nicotine but because of it!

Anyway, this matter clearly needs more investigation and I don't believe smoking cigarettes all day long is of any benefit. I rather suspect it would just worsen the RLS over time. But maybe when you are careful and only consume nicotine at night or on specific days where you have great problems falling asleep, nicotine might help you as long as you are one of those "special cases". And maybe the benefits are more general then I think right now but for sure, smoking all day long will only worsen things.

With that in mind, if you want to use nicotine, don't go for the patches since the intake of nicotine is too slow. Either use gums or as the original posted suggested use those mints which are available in a pharmacy (at least here in Germany). We also have a prescription nasal spray with nicotine for a more rapid onset of action which could be beneficial. Nobody knows. I decided to use an inhaler since it is very easy to dose and I am ex-smoker. So at least for now inhaling is method of choice and I will update you all on my development.

Here are some more interesting facts regarding nicotine:

While acute/initial nicotine intake causes activation of nicotine receptors, chronic low doses of nicotine use leads to desensitisation of nicotine receptors (due to the development of tolerance) and results in an antidepressant effect, with early research showing low dose nicotine patches could be an effective treatment of major depressive disorder in non-smokers.

However, the original research concluded that: "Nicotine patches produced short-term improvement of depression with minor side effects. Because of nicotine's high risk to health, nicotine patches are not recommended for clinical use in depression.

Though tobacco smoking is associated with an increased risk of Alzheimer's disease, there is evidence that nicotine itself has the potential to prevent and treat Alzheimer's disease.

Little research is available in humans but animal research suggests there is potential benefit from nicotine in Parkinson's disease. In humans, there is epidemiologic evidence for a reduced risk of Parkinson's associated with tobacco use, consumption of Solanaceae vegetables in general, and consumption of peppers in particular.

Posts: 519
Joined: Wed Mar 13, 2013 12:53 pm
Location: Berlin / Germany

Re: Nicotine

Postby QyX » Tue Oct 16, 2018 8:03 am

Here is a little update: at least when consumed daily, nicotine doesn't seem beneficial. However there are two key points to make.

1) the dose of nicotine in my vaping liquid is very low


2) right now I am suffering from a major depression which is maybe impacting my sleep way more then RLS.

At the moment it is very hard to tell what's causing what.

For more conclusive results first my depression needs to go away and then I need to stop vaping nicotine and see how things are. Also I am not surprised that I am now depressed. Carbamazepine is a potent mood stabilizer and I'am having depressive episodes since I am a teenger. So not surprising I catched a episode once I stopped Carbamazepine.

I will update this topic once I have more conclusive results.

A bit of a problem is that I enjoy the act of vaping and create big clouds of steam a lot. I could vape liquids without nicotine but the little bit of nicotine also makes it a bit more fun. After all nicotine is psychotropic substance.

But should there be any potential of nicotine for RLS, I think the effects are limited and it will only work as long as there is no significant tolerance to nicotine. Positive effects may last for a maximum of 1-2 months and are probably not strong enough to risk consuming a highly addictive substance even though vaping is way less dangerous than smoking cigarettes and the bioavailability of nicotine when vaped is comparable to the use of nicotine chewing gum. So the little "kick" you might get from smoking cigarettes, you don't have that when just vamping.

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