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Tijdschrift voor Psychiatrie 55 (2013) 6, 415 - 425

Review article

The nicotine receptor as target for the improvement of cognitive symptoms in schizophrenia

C. Quisenaerts, M. Morrens, B. Sabbe

Summary
background Nicotine receptor agonists are drugs that may be useful for the treatment of cognitive symptoms in schizophrenia.
aim By studying the relevant literature we want to investigate to what extent nicotine enhances cognition in patients with schizophrenia and to find out which domains are affected. We also attempt to identify the obstacles that might impede the use, in the future, of nicotine receptor agonists. In addition, we aim to present the most likely neurobiological working mechanism of nicotine.
method We searched the literature using PubMed and the search terms ‘schizophrenia’, (‘nicotine’ or ‘smoking’), ‘cognition’ and ‘P50’.
results Attention and visuo-spatial memory seems to respond favourably to once-only stimulation by nicotine. These results are supported both by the improvement that nicotine brought about in the signal-to-noise ratio in a P50 sensory grating paradigm and by the neurobiological findings. However, the effect of chronic nicotinergic stimulation is less clear.
conclusion There is some evidence that nicotine does have a mild but acute cognition-enhancing effect in patients with schizophrenia. However, nicotine is not suitable for clinical use, because it can have side effects and lead to addiction and desensitisation of the nicotine receptor. Nevertheless, nicotine receptor agonists do have the potential to enhance and stimulate cognition.

keywords cognitive symptoms, nicotine, schizophrenia