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June 16, 2007
Some Antipsychotic Drugs May Improve Neurocognition in Patients With Chronic Schizophrenia
In a newly published study the effects of using various antipsychotics for up to 18 months were studied and compared, in order to determine whether they improved neurocognition in the patients with chronic schizophrenia taking them (patients with schizoaffective disorder were NOT studied).
The results of the randomized double-blind study, reported in the Archives of General Psychiatry that there were small but significant improvements in neurocognition after 2 months use. This effect was seen in each of the antipsychotics studied. Some differences in effect between the antipsychotics were seen, however, after the full 18 months.
The studied antipsychotics were the second-generation (atypical) antipsychotics olanzapine, quetiapine, risperidone and ziprasidone, and one traditional antipsychotic, perphenazine.
After 18 months of treatment, neurocognitive improvement was greatest in the perphenazine group.
In patients treated with quetiapine or ziprasidone, neurocognitive improvement predicted longer time to treatment discontinuation, independent of symptom improvement.
The authors of the study, Richard S.E. Keefe, PhD, and colleagues from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Investigators and the Neurocognitive Working Group, say that the the 2 month results differed from the results of earlier studies. In general, differing results could be due to different inclusion (and exclusion) parameters of the study. For example, patients with tardive dyskinesia were not included in the perphenazine group.
Commenting on the results, R. Walter Heinrichs, PhD, from York University in Toronto, Ontario, Canada, writes
"The small but statistically significant associations between symptomatic and cognitive improvement in the CATIE trial are consistent with the idea that decreases in distress and psychopathologic features lead to enhanced performance ... The unselective and modest cognitive effects of existing medications are a spur to the exploration of these avenues and hence to the discovery of more powerful and focused treatments for schizophrenia."
Read the Article: Antipsychotic Drugs May Improve Neurocognition in Patients With Chronic Schizophrenia (free registration required)
Posted by Jeanie Wolfson at June 16, 2007 09:20 AM
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