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I'm convinced that if it were suddenly discovered today, nicotine would be hailed as a miracle drug.

It has several properties. It's both a stimulant and a relaxant. It helps you focus without burning out your neurons and inducing psychosis like amphetamines.

https://en.wikipedia.org/wiki/Nicotine#Psychoactive_effects

https://en.wikipedia.org/wiki/Nicotine#Enhancing_performance

While there is some risk to it, the actual danger (cancer, heart attack, stroke) from smoking is due to the tar content and other products of combustion from burning tobacco. While nicotine doesn't help blood pressure, it's not the killer that smoking is. It's also somewhat carcinogenic -- again, not as much as tobacco smoke and tar itself. You can find 80 and 90 year old smoking, but you can't really find elderly using cocaine, for example. As far as drugs go, it's relatively safe, for the benefits that it provides.

Also, there are several MAOIs in tobacco smoke. MAOIs are used as last-line anti-depressants, because of their side-effects when taken in large doses. But with tobacco products, a user basically gets a tritrateable MAOI.

If we suddenly discovered nicotine today, I'm convinced that either it or a close chemical cousin would be a the next miracle drug for anxiety and depression.

Perhaps there is a molecular relative of nicotine that could be employed as such, perhaps with less side-effects.



> Also, there are several MAOIs in tobacco smoke. MAOIs are used as last-line anti-depressants, because of their side-effects when taken in large doses. But with tobacco products, a user basically gets a tritrateable MAOI.

Reversible MAOIs are safer than the irreversible ones: https://en.wikipedia.org/wiki/Monoamine_oxidase_inhibitor#Re...

There were some articles in the Boston Globe in 2000 that pointed out that the SSRI Prozac was known to contribute to suicides. I think it was a mistake to allow this drug onto the market.

> If we suddenly discovered nicotine today, I'm convinced that either it or a close chemical cousin would be a the next miracle drug for anxiety and depression.

Niacinamide (Nicotinamide) is somewhat similar to Nicotine.

  Considering these striking homologies, the craving for 
  nicotine might be due, in part, to a misplaced "hunger" 
  for the nutrient, vitamin B3, [...]
-http://www.highfiber.com/~galenvtp/vtlnctnc.htm


I've always wondered: how do they establish a drug causes suicide? I mean they're not literally giving people suicidal thoughts. How do they make people more prone to suicide?


As far as I'm aware, the currently prevailing theory is that many deeply depressed people may be be having suicidal thoughts, but their depression is also so strong that they don't have the energy and/or motivation to actually go through with it. Apathy is winning. As the drugs start to lift you out of the hole of apathy, you suddenly start to have more energy and motivation, but you're still depressed. So you still are suicidal but now you have the ability to go through with it.


This sounds like an apologist's explanation for an inconvenient truth. Sounds reasonable, but falls apart when confronted with actual data.

(Edit: I'm sure you were paraphrasing what you'd read somewhere.)

Here's a quote from the Boston Globe's 5/7/2000 article:

>> Three years before Prozac received approval by the US Food and Drug Administration in late 1987, the German BGA, that country’s FDA equivalent, had such serious reservations about Prozac’s safety that it refused to approve the antidepressant based on Lilly’s studies showing that previously nonsuicidal patients who took the drug had a fivefold higher rate of suicides and suicide attempts than those on older antidepressants, and a threefold higher rate than those taking placebos.

>> Lilly’s own figures, in reports made available to the Globe, indicate that 1 in 100 previously nonsuicidal patients who took the drug in early clinical trials developed a severe form of anxiety and agitation called akathisia, causing them to attempt or commit suicide during the studies.

-- http://ahrp.org/prozac-revisited-concerns-about-suicides-sur... (I don't know anything about this site, but I've read the quote elsewhere so I'm sure it's a true copy of what the Globe actually printed).


Oh yeah, it was definitely just something I've heard a bunch of times, and not something I'd personally looked up the research on. Thank you for the links.


I think you're combining Prozac's increased-suicide effect and the well-known danger zone of depression recovery:

https://youtu.be/NOAgplgTxfc?t=480

I suppose there could be something in Prozac being an engine of recovery without support (or suicide watch), essentially launching people into the danger zone, but I don't know.


Reports of users. If users report suicidal thoughts during tests and in "the field", then the drug is said to be connected to suicides when users of it end up offing themselves.

The official term is "increased risk of suicide", with the reasoning being suicidal thoughts is a necessary precursor to suicide. But nobody's death certificate actually says that a prescription drug was the cause of death, when it was a suicide.


Drugs are tested on healthy people first. If healthy people with previously no thought of suicide suddenly starts feeling suicidal when in a clinical trial of a drug, it could be outside influence and a huge coincidence, but likely not.




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