Niacin Skin Sensitivity Is Increased in Adolescents at Ultra-High Risk for Psychosis

PLoS One. 2016 Feb 19;11(2):e0148429. doi: 10.1371/journal.pone.0148429. eCollection 2016.


Background: Most studies provide evidence that the skin flush response to nicotinic acid (niacin) stimulation is impaired in schizophrenia. However, only little is known about niacin sensitivity in the ultra-high risk (UHR) phase of psychotic disorders.

Methods: We compared visual ratings of niacin sensitivity between adolescents at UHR for psychosis according to the one year transition outcome (UHR-T n = 11; UHR-NT n = 55) with healthy controls (HC n = 25) and first episode schizophrenia patients (FEP n = 25) treated with atypical antipsychotics.

Results: Contrary to our hypothesis niacin sensitivity of the entire UHR group was not attenuated, but significantly increased compared to the HC group, whereas no difference could be found between the UHR-T and UHR-NT groups. As expected, niacin sensitivity of FEP was attenuated compared to HC group. In UHR individuals niacin sensitivity was inversely correlated with omega-6 and -9 fatty acids (FA), but positively correlated with phospholipase A2 (inPLA2) activity, a marker of membrane lipid repair/remodelling.

Conclusions: Increased niacin sensitivity in UHR states likely indicates an impaired balance of eicosanoids and omega-6/-9 FA at a membrane level. Our findings suggest that the emergence of psychosis is associated with an increased mobilisation of eicosanoids prior to the transition to psychosis possibly reflecting a "pro-inflammatory state", whereas thereafter eicosanoid mobilisation seems to be attenuated. Potential treatment implications for the UHR state should be further investigated.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Enzyme Activation
  • Fatty Acids / metabolism
  • Female
  • Flushing / chemically induced
  • Humans
  • Intracellular Space / metabolism
  • Male
  • Niacin / metabolism*
  • Niacin / pharmacology
  • Phospholipases A2 / metabolism
  • Psychotic Disorders / epidemiology*
  • Psychotic Disorders / etiology
  • Psychotic Disorders / metabolism*
  • Risk
  • Skin / drug effects
  • Skin / metabolism*
  • Skin / pathology
  • Young Adult


  • Fatty Acids
  • Niacin
  • Phospholipases A2

Grant support

The study was supported by Stanley Medical Research Institute, grant 03T-315. Dr. G. Paul Amminger was supported by grant 566529 from the National Health and Medical Research Council, Australia. The sponsor of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report.