Medical Bulletin 3/January/2024

Here are the top medical news of the day:

Want to quit smoking in 2024? Cytisine can help

A new study published in Addiction has found that cytisine, a low-cost, generic stop-smoking aid that has been used in eastern Europe since the 1960s, increases the chances of successful smoking cessation by more than two-fold compared with placebo and may be more effective than nicotine replacement therapy. It has a benign safety profile, with no evidence of serious safety concerns. Sounds perfect for your New Year resolution, doesn’t it? But there’s a catch: Cytisine is not licensed or marketed in most countries outside of central and eastern Europe, making it unavailable in most of the world, including many low- and middle-income countries where it could make a big difference to global health.

Cytisine is a plant-based compound that eases smoking withdrawal symptoms. It was first synthesised in Bulgaria in 1964 as Tabex® and later spread to other countries in eastern Europe and Asia, where it is still marketed. In 2017, the Polish pharmaceutical company Aflofarm began selling it as Desmoxan®, a prescription-only medicine, and Canada approved it as an over-the-counter natural health product, Cravv®.

Reference: Want to quit smoking in 2024? Cytisine can help … if you live in the right country; Addiction, DOI: 10.1111/add.16399

Certain migraine medications may be more effective than Ibuprofen

Migraine attacks are characterized by intense throbbing head pain, sensitivity to light and sound, nausea or vomiting. Previous research has shown migraine can also be associated with cognitive issues.

For many people with migraine, it can be difficult to find a treatment that is effective and reliable, and information on how medications compare to one another is lacking. A new study draws data from nearly 300,000 people using a smartphone app to help people make decisions about their medications.

The study found that certain migraine medications like triptans, ergots and anti-emetics may be two to five times more effective than ibuprofen for treating migraine attacks, according to new research published in the issue of Neurology, the medical journal of the American Academy of Neurology.

Reference: Xiaoran Liu, Todd Beck, Klodian Dhana, Pankaja Desai, Kristin R. Krueger, Christy C. Tangney, Thomas M. Holland, Puja Agarwal, Denis A. Evans, Kumar B. Rajan. Association of Whole Grain Consumption and Cognitive Decline. Neurology, 2023; 101 (22): e2277 DOI: 10.1212/WNL.0000000000207938

Light color is less important for the internal clock than originally thought

Light in the evening is thought to be bad for sleep. However, does the color of the light play a role? Researchers from the University of Basel and the Technical University of Munich (TUM) compared the influence of different light colors on the human body. The researchers' findings contradict the results of a previous study in mice.

Vision is a complex process. The visual perception of the environment is created by a combination of different wavelengths of light, which are decoded as colours and brightness in the brain. Photoreceptors in the retina first convert the light into electrical impulses: with sufficient light, the cones enable sharp, detailed, and coloured vision.

"A study in mice in 2019 suggested that yellowish light has a stronger influence on the internal clock than blueish light," says Christine Blume. In humans, the main effect of light on the internal clock and sleep is probably mediated via the light-sensitive ganglion cells. "However, there is reason to believe that the colour of light, which is encoded by the cones, could also be relevant for the internal clock."

Reference: Christine Blume, Christian Cajochen, Isabel Schöllhorn, Helen C. Slawik, Manuel Spitschan. Effects of calibrated blue–yellow changes in light on the human circadian clock. Nature Human Behaviour, 2023; DOI: 10.1038/s41562-023-01791-7