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Heninger GR, Bowers MB. 
“Adverse effects of niacin in emergent psychosis”. 
Journal American Medical Association. 1968;204:1010-1011.
Since 1962, several reports have described the apparently successful treatment of schizophrenia with repeated large doses (up to 3 gm daily) of niacin, either as niacin or niacinamide. All of these studies used a reduction in length of hospitalization as the indicator of drug effect, and although the niacin-treated patients spent fewer days in the hospital, the use of only this one measure of outcome and the lack of replication by other investigators limit the general applicability of the studies. In the New York Times (March 31, 1966), there was a report of successful treatment in three to five days of 13 out of 17 (acute and chronic) schizophrenic patients by administering orally 1 to 2 gm of nicotinamide adenine dinucleotide (NAD), better know as nadide. Subsequently there have been two published reports which fail to demonstrate any therapeutic effects of this compound. Even though the claims of successful niacin therapy in schizophrenia have not received independent support, there continues to exist a belief in its usefulness in some lay and professional circles. We have observed that patients sometimes request niacin be used in their treatment. These requests are little different that numerous other wishes for relief and can usually be successfully dealt with. Of more serious import are those instances where niacin is prescribed and used in an attempt to ward off impending psychosis. In these instances the false sense of security stemming from the belief in the prophylactic value of niacin may lead to serious consequences. In addition there is suggestive evidence that the pharmacologic effects of niacin (particularly the flush) interact and possibly potentiate the psychotic symptoms. The following two case reports illustrate these points.
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