Niacin, an Old Drug, has New Effects on Central Nervous System Disease

ABSTRACT

Increased serum cholesterol and decreased high-density lipoprotein (HDL) cholesterol level in serum and cerebro-spinal fluid is a risk factor for the development of Alzheimer disease, and also a predictor of cardiovascular events and stroke in epidemiologic studies. Niacin (vitamin B³or nicotinic acid) is the most effective medication in current clinical use for increasing HDL cholesterol and it substantially lowers triglycerides and LDL cholesterol. This review provides an update on the role of the increasing HDL cholesterol agent, niacin, as a neuroprotective and neurorestorative agent which promotes angiogenesis and arteriogenesis after stroke and improves neurobehavioral recovery following central nervous system diseases such as stroke, Alzheimer’s disease and multiple sclerosis. The mechanisms underlying the niacin induced neuroprotective and neurorestorative effects after stroke are discussed. The primary focus of this review is on stroke, with shorter discussion on Alzheimer disease and multiple sclerosis.

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