Reduction of Aggressive Episodes After Repeated Transdermal Nicotine Administration in a Hospitalized Adolescent with Autism Spectrum Disorder.
A nicotine patch quickly cut aggression and restraint use for one hospitalized teen with autism.
01Research in Context
What this study did
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.
What they found
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.
How this fits with other research
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.
Why it matters
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.
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02At a glance
03Original abstract
Aggression remains a major cause of morbidity in patients with autism spectrum disorder (ASD). Current pharmacotherapy for aggression is not always effective and is often associated with morbidity. Nicotinic acetylcholinergic neurotransmission may play a prominent role in ASD pathophysiology based on human and animal studies, and preclinical studies show nicotine administration can reduce aggression-related behaviors. Transdermal nicotine has been used to treat agitation in neuropsychiatric conditions with cholinergic dysfunction. Here we report the use of transdermal nicotine as an adjunctive medication to treat aggression in a hospitalized adolescent with ASD. Nicotine patch was recurrently well tolerated, and reduced the need for emergency medication and restraint. These findings suggest further study of transdermal nicotine for aggression comorbid with ASD is warranted.
Journal of autism and developmental disorders, 2015 · doi:10.1093/hmg/ddr357