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Query: UMLS:C0917801 (insomnia)
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In total, our studies show that changes which occur reliably and consistently in chronic smokers after tobacco deprivation include: decreased heart rate, increased caloric intake/eating, increased number of awakenings during sleep, increased craving for tobacco, and increased confusion, as measured by the POMS. Other changes that were found to occur after tobacco deprivation in some but not all of our studies include decreased orthostatic heart rate, increased irritability, and decreased vigor score on the POMS. Previous investigators have found a consistent effect of tobacco deprivation on heart rate (Gilbert and Pope 1982; Knapp et al. 1963; Parsons and Hamme 1975; Weybrew and Stark 1967; Glauser et al. 1970; Myrsten et al. 1977; Murphee and Schultz 1968). Although decreased blood pressure (Knapp et al. 1963; Murphee and Schultz 1968) and changes in other vital signs such as temperature (Gilbert and Pope 1982; Myrsten et al. 1977; Ague 1974) have been reported, our present studies and studies by others (Weybrew and Stark 1967; Glauser et al. 1970) failed to find a significant deprivation effect on these measures. Perhaps the contradictory findings are a function of the reliability of the measures themselves or of the population tested. Caloric intake has been found to increase in both animals and humans after nicotine or smoking cessation (Gruneberg 1982; Myrsten et al. 1977; Wack and Rodin 1982). These results are consistent with studies which have found that smoking cessation causes an increase in body weight (Wack and Rodin 1982). However, previous studies disagree on how smoking cessation causes weight gain. Our inpatient study is believed to be the first to simultaneously measure changes in caloric intake, fluid retention, and physical activity after tobacco deprivation. In the study, caloric intake increased but fluid retention and physical activity did not change. The increases in weight may not be accounted for solely by increases in caloric intake. There may be other factors such as decreased basal metabolic rate which cause the increase in weight. Other studies have also reported sleep disturbance or insomnia among tobacco-deprived smokers (Larson et al. 1961; Weybrew and Stark 1967). Studies directly monitoring sleep have found a decrease in duration awake (Soldatos et al. 1980), increased REM sleep (Soldatos et al. 1980; Kales et al. 1970; Parsons et al. 1975), and increased Stage IV (greater than 50% delta waves) sleep (Parson et al. 1975; Parsons and Hamme 1975). Thus, objective data indicate that after tobacco deprivation smokers actually sleep longer, which contradicts subjective reports of insomnia.(ABSTRACT TRUNCATED AT 400 WORDS)
NIDA Res Monogr 1985
PMID:Characterization of tobacco withdrawal: physiological and subjective effects. 393 46

The National Institute on Drug Abuse has funded a medications program that has concentrated on the development of medications for opiate and cocaine dependence. Levomethadyl acetate (LAAM) and buprenorphine and buprenorphine/naloxone sublingual tablets were developed in conjunction with pharmaceutical partners and approved by the Food and Drug Administration. The remaining challenges for medications development for opiate dependence involves Phase IV studies in special populations, for example, pregnant opiate-dependent patients, and to translate neuroscience-based findings into treatments. Several marketed medications have shown initial efficacy to reduce cocaine use in well-controlled clinical trials. Disulfiram has been shown to reduce cocaine use in several clinical trials, while baclofen, modafinil, naltrexone, ondansetron, tiagabine, and topiramate have shown preliminary efficacy in initial clinical studies. Confirmatory studies of many of these medications is underway. More recently, the NIDA medications program has evaluated medications for their ability to reduce methamphetamine use. To date, no medications tested have shown efficacy to reduce methamphetamine use. Both marketed medications and investigational agents will be tested. Finally, NIDA has begun to test medications for efficacy to reduce cannabis use. Initial studies are underway. Both agonist and antagonist approaches will be evaluated. Additionally, medications will be tested in cannabis-dependent patients for the management of insomnia, withdrawal, and concurrent depression.
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PMID:Medications development: successes and challenges. 1608 66