Niacin supplement in schizophrenia: Hit two birds with one stone.

Corresponding Author: Onur Durmaz, MD; e-mail: [email protected] 2325 Dear Editor, I have read the article written by X.J. Xu and G.S. Jiang with great interest1. This article proposed that the niacin deficiency could have been a contributory factor in development of schizophrenia in a subset of patients as well as an augmentation option in treatment. As mentioned in article, niacin is an important precursor for several metabolic, cellular, oxidative and endothelial pathways associated with cardiovascular and neurological systems. Although schizophrenia is a progressive brain disorder, metabolic problems including metabolic syndrome and comorbid cardiovascular risk factors are highly prevalent in this population due to sedentary lifestyle, antipsychotic side effects and poor dietary choices2. Niacin deficiency has been reported to be associated with some neuropsychiatric disorders. On the other hand, niacin has been shown to improve endothelial function and vascular regeneration regardless of changing lipid profile3, while some reports suggested niacin supplement as an effective treatment method in metabolic syndrome and dyslipidemia4. In addition to authors conclusions, niacin could be a good augmentation medication in patients diagnosed with schizophrenia, particularly in those with metabolic syndrome and obesity or dsylipidemia, in terms of alleviating psychotic symptoms as well as comorbid metabolic and cardiovascular problems that are highly prevalent in this population.