Nicotine is a central nervous system stimulant substance usually found in tobacco and its related products. The most common method for its delivery is via tobacco chewing and smoking comes after it.[1] It starts with occasional use of cigarette or tobacco in stressful conditions or peer pressure but turns into an addiction easily requiring regular usage. The dependence of nicotine has also been included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as tobacco use disorder.

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How Do You Fight Nicotine Withdrawal?

If an individual dependent upon nicotine starts abstaining from it, many new symptoms start to appear which are in response to withdrawal effect of nicotine. Withdrawal indicates physical dependence upon the substance whereas craving indicates psychological dependence on it. Some of the nicotine withdrawal symptoms are depression, decreased concentration ability, loss of alertness, altered sleep pattern, irritability, feeling of craving, loss of interest in the work, weight gain, drowsiness with paradoxical trouble in sleeping, increased appetite, bradycardia, etc.[2] These effects become severe over days and results in rejoining the addiction and failure of quitting. These effects are to be managed for getting success in the quit rate.

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For the acute cases of nicotine withdrawal, symptomatic relief for nausea, vomiting with antiemetic drugs like domperidone can be given. For relieving insomnia, benzodiazepines and are the drugs of choice. For weight gain and increased appetite, anorectic agents like topiramate, lorcaserin, orlistat, bupropion, etc. are very effective in dealing with it.[3] Sublingual tablets of nicotine can be prescribed in acute cases of withdrawal syndrome.

The withdrawal is reduced by usage of nicotine replacement therapy to substitute the amount partially out of the calculated amount of nicotine taken in various forms by the individual. Nicotine replacement therapy has been employed effectively in 50 to 70% of cases and individuals are able to quit smoking. Various forms of replacement therapy are a transdermal patch, tablets, lozenge, nasal spray, chewing gum, inhaler, sublingual tablet, electronic cigarettes, etc. It has proven to be very effective method and is considered safe according to the latest researches and studies except electronic cigarettes which may produce some unwanted effects.

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Can You Overdose On Nicotine?

In spite of start research and various trials on the nicotine and its related products, the lethal dose for nicotine remains unknown in humans and even in animal studies. It is described as LD50 in trials which are defined as the dosage of the substance which can produce 50% mortality. So the overdose of nicotine is undefined and uncalculated.

It can only be assessed by the symptoms appearing on the individual. A person using only smoking methods or chewing methods of tobacco use is highly unlikely to get an overdose of nicotine even when the person is a chain smoker. Nicotine when taken as replacement therapy in the form of transdermal patch, lozenge, etc. also do not develop any overdosage whereas in the form of tablets it can be dangerous and misused very easily and also can produce symptoms of overdosage.

Conclusion

When an individual, who is dependent upon nicotine taken in any form, suddenly stops taking it, it produces a group of symptoms opposite to the nicotine effects which are known as withdrawal symptoms. If the symptoms appear in the dangerous form then it is known as withdrawal syndrome which is a characteristic of physical dependence upon the substance. The psychological dependence does not produce withdrawal effects but only produces craving for the substance. It has been classified in new DSM 5 as tobacco use disorder. Various effective methods are available for nicotine deaddiction via usage of nicotine replacement therapy. It replaces the existing dose of nicotine in partial amount only and also prevents withdrawal effects.

Overdosage due to tobacco smoking or chewing has not been established because the toxic or lethal dose for nicotine is not known. It is highly unlikely for nicotine overdosage to be found in replacement therapies as these are considered safe.

References:  

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Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: August 26, 2019

This article does not provide medical advice. See disclaimer

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