Delirium from nicotine withdrawal in neuro-ICU patients
Abstract
Five cases of presumed nicotine withdrawal delirium among brain-injured patients treated in a neurologic intensive care unit are presented. Each patient had a history of heavy tobacco use and experienced dramatic and sustained clinical improvement within hours of transdermal nicotine replacement. These preliminary observations suggest that nicotine withdrawal may be an under-recognized cause of delirium in patients with acute brain injury.
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Nicotine replacement therapy has been reported as effective in a prior case series of four patients admitted to a neuro-ICU.
“an approach that has been reported as effective in a prior case series of four patients admitted to a neuro-ICU (Mayer et al., 2001).”
From Mood and anxiety regulation by nicotinic acetylcholine receptors: A potential pathway to modulate aggression and related behavioral states (2015) · cites this paper as Mayer et al., 2001
Nicotine withdrawal has been suggested as an underrecognized cause of delirium in patients with acute brain injury.
“Nicotine withdrawal has been suggested as an underrecognized cause of delirium in patients with acute brain injury [41].”
From Nicotine withdrawal and agitation in ventilated critically ill patients (2010) · cites this paper as [41]
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Nicotine Withdrawal Syndrome in Intensive Care Patients—Preventive and Therapeutic Implications
Piotrkowska, R., Miszewska, A., Lange, S., Mędrzycka-Dąbrowska, W. A., & Krupa, S. (2026) · Medical Sciences · doi:10.3390/medsci14030374
- Authors
- Mayer, S. A., Chong, J. Y., Ridgway, E., Min, K. C., Commichau, C., & Bernardini, G. L.
- Affiliations
- Columbia University Irving Medical Center (US)
- Venue
- Neurology
- Published
- 2001-08-14
- Volume
- 57
- Issue
- 3
- Pages
- 551-553
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- OpenAlex
- W2128979752
- Cited by
- 74
- References
- 12
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 3 · 2022: 3 · 2020: 1 · 2019: 2 · 2018: 2 · 2017: 3 · 2016: 3 · 2015: 2 · 2014: 2 · 2013: 2 · 2012: 6
- FWCI
- 2.81
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neurology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Health Sciences › Medicine › Neurology › Alcoholism and Thiamine Deficiency
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Keywords
- nicotine withdrawal, delirium, acute brain injury, neurologic intensive care, tobacco use, clinical improvement
- MeSH terms
- Administration, Cutaneous, Adult, Aged, Delirium, Female, Humans, Intensive Care Units, Male, Nervous System Diseases, Nicotine, Substance Withdrawal Syndrome
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