Reduction of Aggressive Episodes After Repeated Transdermal Nicotine Administration in a Hospitalized Adolescent with Autism Spectrum Disorder.

Doctors added a nicotine patch to the care of one hospitalized teen with autism. The teen had many aggressive outbursts and often needed restraint. Staff kept daily notes on aggression and restraint use while the patch stayed on.

Aggressive episodes dropped and staff used restraints less often. The teen did not report any side effects. The patch was well tolerated for the whole stay.

Heald et al. (2020) showed that nicotine improved social behavior and cut repetitive movements in autism-model mice. Their work hints that nicotine receptors may calm core autism signs, not just aggression.

Huguenin (2000) reviewed many drugs for autism-related aggression and found no single pill works for everyone. That review supports trying add-on options like the patch while keeping behavioral plans in place.

Malagodi et al. (1989) used group anger training to reduce aggression in typical teens living in a residential unit. Both studies show fewer aggressive acts, but one used a drug and the other used talk-and-relax skills.

You now have a low-risk option to discuss with the medical team when severe aggression continues despite behavior plans. Ask the prescribing doctor if a nicotine patch trial fits the client’s profile. Track aggression and restraint use daily so you can decide to continue or stop within one week.

Aggression is a major source of harm in ASD, and standard medications are not always effective or well tolerated. This report describes transdermal nicotine used as an adjunctive medication for a hospitalized adolescent with autism.

The nicotine patch was repeatedly well tolerated and was associated with reduced aggressive episodes and a lower need for emergency medication and physical restraint. The rationale draws on nicotinic cholinergic involvement in ASD.

This is a single case, not a controlled trial, so it cannot establish efficacy or safety. It is best read as a signal that transdermal nicotine for aggression comorbid with ASD warrants further, controlled study.

Behavior analysts should not infer a treatment recommendation from one case. Function-based behavioral assessment and intervention remain first-line, with any medication decision made by a prescribing physician.