Work

Niacin skin flushing response in patients with schizophrenia: Associations with the efficacy of modified electroconvulsive therapy and clinical symptoms

Year: 2025

Type: article

Abstract: OBJECTIVE: Schizophrenia (SZ) is a group of chronic neurodevelopmental disorders, and antipsychotic medication is the main clinical treatment. However, approximately one-third of patients demonstrate inadequate response to these medications, which is termed treatment-resistant schizophrenia (TRS). The primary objective of this study was to explore the clinical characteristics of patients with TRS, including positive, negative, general psychotic symptoms and niacin skin flushing response (NSFR), which is considered an auxiliary diagnostic biomarker for SZ, and the improvement of these characteristics after modified electroconvulsive therapy (MECT). METHODS: This study included 32 patients with TRS, who received MECT combined with antipsychotic medication (SZ-MECT group), and 30 patients with non-treatment-resistant SZ (N-TRS), who received antipsychotic medication alone (SZ-N group). We assessed disease severity with the Positive and Negative Syndrome Scale (PANSS) and NSFR at baseline and at weeks 2, 4, and 6 in all patients. RESULTS: At baseline, the SZ-MECT group had greater PANSS scores (P < 0.0001) and a more blunted NSFR (P = 0.020) than the SZ-N group did, and the PANSS-TOTAL scores were negatively correlated with the NSFR scores (r = -0.361, P = 0.0039). At week 6 after treatment, the SZ-MECT group presented significantly improved PANSS scores (P < 0.0001) and NSFR blunting (P = 0.010) that were comparable with those in the SZ-N group. CONCLUSION: Compared with patients with N-TRS, patients with TRS presented more severe clinical symptoms and a more blunted NSFR, which significantly improved after MECT treatment. The NSFR may have good clinical application potential as an auxiliary assessment of severity and MECT efficacy in patients with schizophrenia.

Source: Journal of Psychiatric Research

DOI: 10.1016/j.jpsychires.2025.04.025