TY  - JOUR
T1  - EFfects of moderate-dose treatment with varenicline on neurobiological and cognitive biomarkers in smokers and nonsmokers with schizophrenia or schizoaffective disorder
AU  - Hong L, Thaker GK, McMahon RP, et al
Y1  - 2011/12/01
N1  - 10.1001/archgenpsychiatry.2011.83
JO  - Archives of General Psychiatry
SP  - 1195
EP  - 1206
VL  - 68
IS  - 12
N2  - Context 
                  The administration of nicotine transiently improves many neurobiological and cognitive functions in schizophrenia and schizoaffective disorder. It is not yet clear which nicotinic acetylcholine receptor (nAChR) subtype or subtypes are responsible for these seemingly pervasive nicotinic effects in schizophrenia and schizoaffective disorder.Objective 
                  Becauseα4β2 is a key nAChR subtype for nicotinic actions, we investigated the effect of varenicline tartrate, a relatively specificα4β2 partial agonist and antagonist, on key biomarkers that are associated with schizophrenia and are previously shown to be responsive to nicotinic challenge in humans.Design 
                  A double-blind, parallel, randomized, placebo-controlled trial of patients with schizophrenia or schizoaffective disorder to examine the effects of varenicline on biomarkers at 2 weeks (short-term treatment) and 8 weeks (long-term treatment), using a slow titration and moderate dosing strategy for retainingα4β2-specific effects while minimizing adverse effects.Setting 
                  Outpatient clinics.Participants 
                  A total of 69 smoking and nonsmoking patients; 64 patients completed week 2, and 59 patients completed week 8.Intervention 
                  Varenicline.Main Outcome Measures 
                  Prepulse inhibition, sensory gating, antisaccade, spatial working memory, eye tracking, processing speed, and sustained attention.Results 
                  A moderate dose of varenicline (1) significantly reduced the P50 sensory gating deficit in nonsmokers after long-term treatment (P = .006), (2) reduced startle reactivity (P = .02) regardless of baseline smoking status, and (3) improved executive function by reducing the antisaccadic error rate (P = .03) regardless of smoking status. A moderate dose of varenicline had no significant effect on spatial working memory, predictive and maintenance pursuit measures, processing speed, or sustained attention by Conners' Continuous Performance Test. Clinically, there was no evidence of exacerbation of psychiatric symptoms, psychosis, depression, or suicidality using a gradual titration (1-mg daily dose).Conclusions 
                  Moderate-dose treatment with varenicline has a unique treatment profile on core schizophrenia-related biomarkers. Further development is warranted for specific nAChR compounds and dosing and duration strategies to target subgroups of schizophrenic patients with specific biological deficits.Trial Registration 
                  clinicaltrials.gov Identifier: NCT00492349
SN  - 0003-990X
M3  - doi: 10.1001/archgenpsychiatry.2011.83
UR  - http://dx.doi.org/10.1001/archgenpsychiatry.2011.83
ER  -