The Cognitive Effects of Niaspan as an Adjunct to Atypical Antipsychotic Medication in the Treatment of First Episode Psychosis: A Case Study

Poster B33, Friday, October 21, 11:30 am - 1:00 pm, Le Baron

Dr. Heather Milliken1,2, Dr. Beverly Butler1,2, Lorelei Audas2; 1Dalhousie University, 2Nova Scotia Health Authority

In first episode psychosis (FEP), the effect of niacin/nicotinamide on cognitive functioning has not been systematically investigated. The primary objective of the larger randomized, open-label, flexible dose trial was to evaluate the impact of Niaspan as an adjunct to antipsychotic medication (FEP/N+) versus antipsychotic medication alone (FEP/N-) on cognitive, symptomatic and functional outcomes in the treatment of FEP. For this analysis, two pairs of FEP participants (FEP/N- versus FEP/N+) were matched on clinical measures at baseline (CGI-S, PANSS and SOFAS) and changes in cognitive performance (reaction time and accuracy) were analyzed at 3- and 6-months. Cognitive measures included the MATRICS Consensus Cognitive Battery (MCCB) and an experimental measure of attention and executive functioning (the Dalhousie Computerized Attention Battery: DalCAB). In one moderately-ill pair (CGI-S: 4) FEP/N- exhibited improvements over time (reliable change index: > -1.96) on tasks of visual learning, problem solving and speed of processing, but declines (reliable change index: < -1.96) on measures of executive functioning, while FEP/N+ exhibited declines on tasks of speed of processing and spatial working memory, but improvement on a task of verbal working memory. In the second mildly ill pair (CGI-S: 3) FEP/N- declined on measures of speed of processing, switching and filtering, while FEP/N+ improved on measures of verbal learning, response switching and increased working memory load (dual task). These case comparisons suggest that Niaspan as an adjunct to atypical antipsychotic medication varies in its ability to maintain or improve cognitive performance relative to antipsychotic medication alone in first episode psychosis individuals.

Topic Area: Neurocognition

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