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    Can Nicotine withdrawal cause anxiety symptoms?

Posted on Mon, 5 Oct 2015 in Medicines and Side Effects
Question: Hello Doctor

Since 2 years I was taking 2mg Nicotex (Nicotine Gum) to quit smoking. Well i did give up my smoking habits while on Nictone Replacement Therapy(NRT) But the side effects of this gum has started to give nightmares. I realized this on 25th august when one night i couldn't sleep and witnessed excessive hair fail since past few days. Since then i am experiencing certain symptoms everyday which are
1)Heaviness in Head
2)Shortness of Breadth
4)Constant Body Movement
5)Excess Salivation In Mouth
6)Sudden Increase in Heart Beat
8)Difficulty concentrating

While i have given up smoking and chewing gums since then, these are some symptoms which come and go even today. Besides this I had also completed full body tests which are
1)Lipid Profile Complete
2)Blood Sugar
5)Potassium Sodium Calcium
7)Heart Test (Holter, Echo And Ecg)

All my medical reports were reported normal. But still the symptoms persist even today. I feel something has gone wrong in my body but medical reports and i am unable to identify what has gone wrong. I would like to seek help from you so as to know why am i experiencing these symptoms when all the medical reports are normal. Is there any way by which my body will go back to Normal. If yes how long will it take me to be completely healthy again. I hope so the possibility of a serious disease can be ruled out in my case because sometimes i am perfectly all right but sometimes god know what happens to me. My body starts acting funny i guess.. I would like to seek help from you so as to overcome these problems.

Answered by Dr. Shubham Mehta 1 hour later
Brief Answer:
most probably, these are effects of nicotine.

Detailed Answer:
Hello Dear XXXXXXX
Welcome to HCM.

I can understand your concerns.

You have been on NRT since two years and stopped it since 25 august.

Now you have developed the symptoms like heaviness in head, shortness in breath etc.

I would like to tell you that nicotine is a stimulant drug. Excessive nicotine as well as nicotine withdrawal can cause anxiety symptoms.

I do not think there is any serious illness. You investigations are also normal.
This further indicates that there is no major illness.
I strongly feel these symptoms to be due to nicotine.

I have some suggestions for you:
1. Never restart smoking in future. This may lead you to panic attacks.
2. Avoid caffeinated drinks like tea, coffee and alcohol.
3. Practice relaxation exercises like deep breathing abd meditation.
4. Drinks plenty of water to allow faster washout of nicotine from body.
5. Some antioxidant supplements like those of omega 3 fatty acids and multivitamin and multuminerals can help to control your symptoms.
6. Take adequate sleep.
7. Increase intake of green vegetables in your diet.
8. If the symptoms are disabling, you can take clonazepam (only on SOS basis) to abort acute anxiety symptoms. (Prescription drug).

You will certainly become normal.
But every individual has different metabolism. It may take 2-3 months for these symptoms to resolve.
Try to follow above tips for a faster relief.

You can also consult a psychiatrist for biofeedback therapy for relaxation.

Hope you find these suggestions helpful.
Feel free to ask further.

I wish for your speedy recovery.

Above answer was peer-reviewed by : Dr. Sonia Raina
Follow up: Dr. Shubham Mehta 1 hour later
Hello Doctor

Thanks for a quick response. I wanted to ask few more questions 1)Am i going through a withdrawal stage and can i rule out the possibility of cancer? 2)How long does it take Nicotine, Cotinine and similar toxic wastes to leave the body completely. 3)I think nicotine overdose has caused changes in Chemistry of my brain which is why the symptoms occur suddenly. I wanted to know if there is any medicine which i can take for a speedy recovery to allow my body to become normal once again as quickly as possible. I am asking this because i have my IBPS bank exams on 4th October and 31st October and i am unable to put in the best efforts in my studies. I want to recover as soon as possible. Please help me. Thank You
Answered by Dr. Shubham Mehta 4 hours later
Brief Answer:
it may take 2-3 months to recover completely.

Detailed Answer:
I think you are experiencing the symptoms of nicotine withdrawal.

You have undergone most of the investigations which are normal.
To rule out cancer (especially lungs), chest HRCT scan will be the sufficient investigation. But I think you do not need it.

Nicotine has short half life of 1-2 hours and cotinine has half life of 18-20 hours.
These products leave the body fast. But you are taking these since long, so it may take 2-3 months for withdrawal symptoms to resolve completely.

Unfortunately, there is no specific medicine to end these symptoms immediately. But if you can try to follow the tips which I mentioned earlier, this should fasten your recovery.

I understand that you have your exams. But these drugs of abuse does affect the body chemistry significantly. Time is the best medicine.

I wish all the best for your exams.
Hoping for your speedy recovery.

Feel free to ask further.
Above answer was peer-reviewed by : Dr. Prasad
Follow up: Dr. Shubham Mehta 45 minutes later
Hello Doctor
I am really going through a bad phase and i am writing this message amidst lots of problems which i mentioned earlier. Suddenly my head starts feeling heavy as if i am being strangulated . this is how i feel. Also i am confused with blurry vision. There is no fix time of influx of the symptoms. It happens at any moment... What i wanted to know to is the withdrawal symptoms that i am experiencing right now , will it normalize within 1 month or i will need to cope up with these symptoms for 3 long months. Please offer some unconditional support so that i can control the symptoms when it arrives.. Thanks for your timely response.
Answered by Dr. Shubham Mehta 4 hours later
Brief Answer:
tablet clonazepam should help.

Detailed Answer:

The severity of withdrawal symptoms should decrease in another 2-3 weeks.
But complete resolution may take 2-3 months.

As you are having severe symptoms, I would suggest that tablet clonazepam (prescription drug) will help you to relieve these symptoms.

You can take this drug till you have your exams and symptoms are severe.

Kindly consult your local doctor for a valid prescription.
Hope this helps.

I wish you well.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Shubham Mehta 20 hours later
Hello Doctor

Thank you once again for your assistance. One thing about me i want to share is, i am of inquisitive nature. Since medical field is not my area of study i would like to know why is that a person passes through the withdrawal stage. Why am i going through a tremendous difficult stage even after giving up smoking and NRT. I agree that smoking causes changes in the functioning of our body but wouldn't it be easy to live like a normal human being immediately after abandoning nicotine.
Answered by Dr. Shubham Mehta 15 hours later
Brief Answer:
neurochemical changes in brain.

Detailed Answer:
Hello again.

Sorry for the late response.

I will try to answer to your curiosity in simple terms so that you are able to understand.

Any drug of abuse stimulates release of dopamine (a neurochemical which generates pleasure) in brain. As the person takes the drug repeatedly, the dopamine firing in brain increases. This leads to formation of new circuits in brain. The brain and body gets used to this pleasurable stimulus and thus dependence.

Now, when the drug is stopped, these new circuits and thus brain, craves for dopamine.
As dopamine is not available, the brain and body reacts negatively which results in psychological and physical withdrawal symptoms.

The difference between smoking and NRT is that smoke contains harmful chemicals whereas NRT has pure nicotine. The logic behind this is to stimulate brain as earlier but avoid harmful chemicals of smoke.
Then NRT is gradually withdrawn.

The body takes time to readjust without those rewards produced by nicotine.
The duration of withdrawal symptoms varies from person to person.

For further details you can google "neurobiology of drug dependence". You will get the details about this vast topic.

Hope this addresses your curiosity satisfactorily.

Feel free to ask further.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by
Dr. Shubham Mehta


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