An Exploratory Trial of Transdermal Nicotine for Aggression and Irritability in Adults with Autism Spectrum Disorder.

DRUG therapy for aggression; THERAPEUTIC use of nicotine; CHOLINERGIC receptors; AFFECTIVE disorders; AUTISM; CROSSOVER trials; DRUG administration; NICOTINE; RESEARCH; STATISTICAL sampling; SLEEP; TRANSDERMAL medication; RANDOMIZED controlled trials; TREATMENT effectiveness; BLIND experiment; SYMPTOMS; ADULTS

Nicotinic acetylcholine receptors (nAChRs), particularly the α7 nAChR, are implicated in the pathophysiology of both autism spectrum disorder (ASD) and aggressive behavior. We explored the feasibility, tolerability, and preliminary efficacy of targeting nAChRs using transdermal nicotine to reduce aggressive symptoms in adults with ASD. Eight subjects were randomized in a double-blind crossover trial of 7 mg transdermal nicotine or placebo, each for 1 week. All participants tolerated nicotine treatment well. Five subjects contributed data to the primary outcome, Aberrant Behavior Checklist-Irritability (ABC-I) subscale change from baseline, which was improved by nicotine compared to placebo. Sleep ratings were also improved by nicotine and correlated with ABC-I improvement. These findings support further investigation of nAChR agonists for aggression and sleep in ASD. [ABSTRACT FROM AUTHOR]

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