Ritalin for nicotine withdrawal: Nesbitt's paradox revisited.

This was a unblinded clinical trial of the stimulant methylphenidate (Ritalin) for nicotine withdrawal. Nineteen nicotine-dependent smokers received oral methylphenidate (30 mg target daily dosage) for 5 days following abrupt cessation. Tobacco withdrawal, Spielberger state anxiety, blood pressure, and pulse were measured at baseline, then serially for 7 days. Tobacco withdrawal and state anxiety increased significantly, but 12 (71%) of the 17 smokers who completed the study rated withdrawal relief "very define" and 13 (76%) rated this quit attempt "much easier than other times." Methylphenidate neither increased blood pressure nor blocked cessation-related pulse decrease and appears safe for this indication. Twelve (63%) of the enrolled smokers were confirmed abstinent at day 5. Methylphenidate effect on nicotine withdrawal should be studied in a placebo-controlled clinical trial.