Mental Health

Modest cognitive benefit with antipsychotics in schizophrenia


 Modest cognitive benefit with antipsychotics in schizophrenia

July 2010 Browse Archive: Go

MedWire News: Schizophrenia patients treated with antipsychotics over a 2-year period show modest improvement in cognitive test performance, study results show.

However, contrary to prevailing opinion, there was no difference between conventional and atypical psychotics in cognitive improvement, and the researchers say that a decision to switch to the latter medication should not be taken solely based on cognition.

“Atypical antipsychotics provide better control of the negative and affective symptoms of schizophrenia when compared with conventional neuroleptics; nevertheless, their heightened ability to improve cognitive dysfunction remains a matter of debate,” write Gabriel Selva-Vera (University of Valencia, Spain) and colleagues in the journal BMC Psychiatry.

In the current study, the researchers recruited a sample of schizophrenia patients taking either conventional (n=13) or atypical antipsychotics (n=26). They performed a battery of neuropsychological at baseline and at 2 years of follow-up.

July 2010 Browse Archive: Go

MedWire News: Schizophrenia patients treated with antipsychotics over a 2-year period show modest improvement in cognitive test performance, study results show.

However, contrary to prevailing opinion, there was no difference between conventional and atypical psychotics in cognitive improvement, and the researchers say that a decision to switch to the latter medication should not be taken solely based on cognition.

“Atypical antipsychotics provide better control of the negative and affective symptoms of schizophrenia when compared with conventional neuroleptics; nevertheless, their heightened ability to improve cognitive dysfunction remains a matter of debate,” write Gabriel Selva-Vera (University of Valencia, Spain) and colleagues in the journal BMC Psychiatry.

In the current study, the researchers recruited a sample of schizophrenia patients taking either conventional (n=13) or atypical antipsychotics (n=26). They performed a battery of neuropsychological at baseline and at 2 years of follow-up.

Overall, the schizophrenia patients showed a significant improvement in the domains of semantic verbal fluency, executive function, visual memory, and auditory immediate memory. Effects sizes were moderate, with clinical relevance greater in the two verbal fluency tasks and visual/auditory memory (Rey figure immediate recall and Digit Span Test forward), where effects sizes were all over 0.6.

By contrast, no cognitive improvements were observed in visual/motor processing, motor speed, and working memory tasks.

Patients taking atypical antipsychotics did not show greater cognitive enhancement over the 2 years than patients taking conventional antipsychotics.

The researchers say that the general improved tolerability profile of atypical antipsychotics, especially with regard to neurological side effects, may facilitate treatment adherence, which in turn may result in greater cognitive improvement.

Nevertheless, in the absence of other reasons to change ongoing treatment, the switch from typical to atypical antipsychotics should not be justified based solely on the expectation of a more favorable cognitive outcome.

Selva-Vera and colleagues conclude by saying that other psychopharmacological and psychosocial strategies should be implemented to enhance cognitive outcome in schizophrenic patients.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

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