Effects of Nicotine Nasal Spray on Cognitive Function in Schizophrenia

Department of Psychiatry, New York University Medical School, Hewlett, NY, USA.
Neuropsychopharmacology (Impact Factor: 7.05). 04/2006; 31(3):637-43. DOI: 10.1038/sj.npp.1300881
Source: PubMed


Schizophrenics have among the highest rates of cigarette smoking. Some studies indicate that cigarette smoking or nicotine may ameliorate some of the cognitive or theoretically related neurophysiological deficits seen in schizophrenic patients. This study investigated the effects of nicotine nasal spray on measures of attention, verbal memory, and visual-spatial memory in schizophrenic patients who were chronic smokers, using a double-blind placebo-controlled pre-post experimental design. Compared to placebo, active nicotine spray significantly decreased reaction time on the Conner's CPT and improved scores on a measure purported to reflect spatial working memory on a dot task. There were trends for the increased number of hits and decreased number of errors in pre-post comparisons on the CPT task in the active nicotine session. There were no effects of active nicotine nasal spray on verbal memory. Our results suggest that nicotine may modestly enhance attention and spatial working memory in schizophrenic patients who are cigarette smokers and have been abstinent overnight.

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Available from: Jessy Warner-Cohen, May 16, 2014
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    • "Consistent with this view, deficits in α7 as well as in α4β2 nicotinic receptors have been associated with cognitive impairment in schizophrenia patients.9,10 On the other hand, nicotine administration to schizophrenia patients has been reported to improve several cognitive tasks that are usually found to be impaired in schizophrenia patients, such as attention and working memory.11,12 In a recent work, acute nicotine has been found to normalize temporal aspects of sensory memory processing in a sample of twelve smokers with schizophrenia compared to twelve control smokers.13 "
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    ABSTRACT: Tobacco smoking is common in schizophrenia patients. It has been reported that schizophrenia patients who are tobacco smokers have better cognitive performances compared to those who are nonsmokers. However, little is known on the effects of tobacco smoking in treatment-resistant schizophrenia (TRS) patients. The aim of this study was to compare cognitive performances, psychotic symptoms, and social adjustment in tobacco smoker TRS patients compared to nonsmoker TRS patients. Smoker and nonsmoker TRS patients did not differ in demographics and in mean daily antipsychotic dose. Smoker TRS patients had significantly higher scores than nonsmoker patients on the positive and negative syndrome scale (PANSS) and on the negative symptoms subscale. These patients also performed worse than nonsmoker patients on problem-solving cognitive domain. Social adjustment was not significantly different between the two groups. In both groups of patients, worse cognitive performances were mostly predicted by higher severity of negative symptoms. Worse performances on the verbal memory and problem-solving cognitive domains were correlated with social-functioning impairment in tobacco smoker TRS patients but not in nonsmoker ones. The results showed that tobacco smoking was not significantly associated with better cognitive performances in TRS patients, while it was significantly associated with higher negative symptoms. Even if a direct causative mechanism cannot be inferred and despite the fact that these patients may use tobacco to self-medicate, it could be speculated that these associations may, at least partially, be related to a tobacco-smoking-induced worsening of abnormal dopamine dysfunction, which has been suggested to occur in TRS patients.
    Full-text · Article · Aug 2013 · Neuropsychiatric Disease and Treatment
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    • "On the other hand, the effect of nicotine on neuroplasticity is controversial, and its improvement and deterioration by NAD have been described. In fact, the investigation by several research groups about the effect of nicotine on attention (Kadir et al., 2006) and learning and memory have given heterogeneous results (Smith et al., 2006). Grundey et al. (2012) show new evidence of a negative effect of nicotine spray on facilitatory plasticity and a diminished reduction in excitability after transcranial direct current stimulation. "

    Full-text · Article · May 2013 · Frontiers in Pharmacology
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    • "This type of classification is commonly used in the tobacco literature (Hughes et al., 2000) and is important as it may help to elucidate whether effects of cannabis on cognition are best characterized as state or trait phenomena. Third, given that cannabis users are more likely to be cigarette smokers (Margolese et al., 2004) and that cigarette smoking is associated with better cognitive performance in schizophrenia (Sacco et al., 2005; Smith et al., 2006), this study controlled for daily tobacco use by only including current tobacco smokers. Likewise, polysubstance abuse is common among this population and these substances (e.g., alcohol, cocaine, stimulants and hallucinogens) are associated with altered cognitive performance (Coulston et al., 2007b), and as such their level of use was considered. "
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    ABSTRACT: Cognitive impairment and cannabis use are common among patients with schizophrenia. However, the moderating role of cannabis on cognition remains unclear. We sought to examine cognitive performance as a function of cannabis use patterns in schizophrenia. A secondary aim was to determine the effects of cumulative cannabis exposure on cognition. Cognition was assessed in male outpatients with current cannabis dependence (n=18) and no current cannabis use disorders (n=29). We then parsed non-current users into patients with lifetime cannabis dependence (n=21) and no lifetime cannabis dependence (n=8). Finally, as an exploratory analysis we examined relationships between cumulative cannabis exposure and cognition in lifetime dependent patients. Cross-sectional comparisons suggest that lifetime cannabis users demonstrate better processing speed than patients with no lifetime dependence. Exploratory analyses indicated that patients with current dependence exhibited robust negative relationships between cumulative cannabis exposure and cognition; these associations were absent in former users. Cannabis status has minimal effects on cognition in males with schizophrenia. However, cumulative cannabis exposure significantly impairs cognition in current, but not former users, suggesting that the state dependent negative effects of cannabis may be reversed with sustained abstinence. Prospective studies are needed to confirm these findings.
    Full-text · Article · Dec 2012
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