What nicotine does to your brain

... we'll never know from this paywalled article

I am diagnosed ADHD. I have used dexamphetamine as prescribed which worked pretty well, in moderate dosages because I am sensitive, but I came to dislike the effect it had on me: I felt like I was attached to a horse that kept pulling me around even when I just wanted to stop and take a break. And the fact that I would crash 5 hours later.

In 2020, before even knowing I had ADHD, let alone being medicated, I managed to quit my (vaped) nicotine habit after using progressively smaller patches; meanwhile my executive dysfunction grew so much, during the most stressful time of my entire life, that I literally had a major nervous breakdown. It took years of therapy, diagnosis with ADHD, medication, to connect the two factors: I had been self-medicating with nicotine by entire life, and as I reduced the amount of it in my bloodstream, the more scattered I became [1]

Then I tested my theory: I bought some nicotine patches, cut at very low dosage. And lo! it was as effective as dexamphetamine was, with much fewer of the side-effects, no pulling effect [2] and cheaper. It's been now a year and a half and honestly it's been working great. I slap on a small patch in the morning, it lasts MUCH longer than a pill, and it even allowed me to move and still lead a productive life in a country where ADHD is not even recognised. I asked my psychiatrist and they confirmed that nicotine is known to work as a third-line medication but usually amphetamines are preferred.

This is not medical advice, yadda yadda, but worked for me, and I've always wanted to write a post about it. Regarding addiction: pretty much none, patches take too long to take effect to create addiction (i.e. caused by a predicable spike in dopamine). My dosage (~7.5mg patch cut out from a larger one) has been the same for the past 18 months, and trying larger doses just makes me sleepy (nicotine has a U-shaped effectiveness curve). Nicotine is much maligned, but if you do the research, avoid the smoking and inhalation devices but only use patches, maybe you'll find it helps you as well.

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1: I read that cigarette smoke during the formative years is associated with lifelong ADHD, and my pet (silly) theory is that the increasing stigma surrounding smoking of the past ~30 years might be one of the many factors we see ADHD on the rise. We might have 2 or 3 generations of smoking parents that were themselves self-medicating because of growing up in times where smoking was commonplace.

2: if I need to feel like a productive machine for a couple hours, coffee and a tyrosine pill can recreate the amphetamine feeling pretty well

TLDR;

• Nicotine boosts attention, memory and alertness by releasing dopamine and other neurotransmitters.

• It’s far less harmful than tobacco but highly addictive.

• Some evidence hints at therapeutic effects in Alzheimer’s, Parkinson’s and schizophrenia models.

• Developing brains (foetus, adolescence) show lasting harm in animal studies.

It does seem to help with focus, but my attempts to curb adhd and brain fog happily didn’t stop at nicotine. Niacinamide (B3) seems to do much better job for me, without the smell, nausea, and it works longer.