Alzheimer’s drug may help smokers quit
University of Pennsylvania researchers Rebecca Ashare and Heath Schmidt studied an Alzheimer’s drug to help people stop smoking.
In a study consisting of a rat trial and a human trial, Ashare and Schmidt studied the effects of two acetylcholinesterase inhibitors, or AChEIs, called galantamine and donepezil on overall nicotine intake. The rat component showed that pretreating the rodents with an AChEI decreased their nicotine consumption. Consistent with these effects, clinical trial participants taking the AChEI, not the placebo, smoked 2.3 fewer cigarettes daily, a 12 percent decrease, and noted feeling less satisfied with the cigarettes they did smoke.
“We’re very interested in screening potential efficacy of anti-addiction medications in our models,” said Schmidt, a professor in Penn’s School of Nursing and Perelman School of Medicine. “For this study, we looked at potential smoking-cessation medications.”
For both drugs, “we were able to show a reduction in total nicotine self-administered,” Schmidt said; however, there was a caveat.
“We know from the literature that upward of 30 percent of patients will report nausea and vomiting [when taking these drugs], and this will limit their compliance,” he said. “We had seen that these drugs reduced nicotine self-administration, but we wanted to make sure it wasn’t because the rats were sick.”
People who were interested in quitting smoking signed on for 23 days. For the first two weeks, they continued to smoke but also took either galantamine or a placebo. Before the trial began, researchers assessed the smokers’ cognitive function to get a baseline. Participants followed the regimen for two weeks and then were asked to not smoke for one full day. Two more assessments took place: after the two weeks on the cigarette-drug combination and again after that initial smoke-free day. Finally, the researchers asked the study subjects to do their best to not smoke for seven straight days, a time during which the participants still took either galantamine or a placebo.
“That week-long period is a proxy for longer-term cessation. The ability to quit smoking the first week after you make a quit attempt is highly predictive of long-term success,” Ashare said.
She’s still actively recruiting for the trial, with an aim of 80 people total. What she’s learned so far — that smokers who used the FDA-approved galantamine smoked fewer cigarettes per day and enjoyed them less — is promising, particularly given that those who don’t smoke during that first crucial week are 32 times more likely to quit smoking permanently.
Ashare and Schmidt published their work in the Nature journal Translational Psychiatry.
