Cognitive effects of atypical antipsychotics: focus on bipolar spectrum disorders

MacQueen, Glenda; Young, Trevor

doi:10.1111/j.1399-2406.2003.00059.x

Cited by 64 publications

(49 citation statements)

References 104 publications

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“…In fact, there is evidence that performance on cognitive tests declines as a function of past illness burden, 154,162,163 and that a past history of alcohol abuse can impact on cognitive performance in certain domains. 164 Neither the short-nor long-term impact of medication on cognitive performance is known, 165 and evidence is just emerging supporting a recurrent or even chronic dysregulation of HPA axis function in BD. 166,167 It is important, therefore, that potential cognitive endophenotypes be studied in unaffected family members of BD probands.…”

Section: Cognitive Endophenotypesmentioning

confidence: 99%

The phenotypes of bipolar disorder: relevance for genetic investigations

2005

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The search for susceptibility genes for bipolar disorder (BD) depends on appropriate definitions of the phenotype. In this paper, we review data on diagnosis and clinical features of BD that could be used in genetic studies to better characterize patients or to define homogeneous subgroups. Clinical symptoms, long-term course, comorbid conditions, and response to prophylactic treatment may define groups associated with more or less specific loci. One such group is characterized by symptoms of psychosis and linkage to 13q and 22q. A second group includes mainly bipolar II patients with comorbid panic disorder, rapid mood switching, and evidence of chromosome 18 linkage. A third group comprises typical BD with an episodic course and favourable response to lithium prophylaxis. Reproducibility of cognitive deficits across studies raises the possibility of using cognitive profiles as endophenotypes of BD, with deficits in verbal explicit memory and executive function commonly reported. Brain imaging provides a more ambiguous data set consistent with heterogeneity of the illness. Keywords: bipolar disorder; genetics; endophenotype; neurocognitive function; brain imaging Bipolar disorder (BD) has a genetic basis with heritability of at least 80%. 1 A number of studies have attempted to map the susceptibility loci giving evidence of linkage in multiple genomic regions. In particular, findings in 4p, 4q, 8q, 10p, 12q24, 13q, 18p, 18q, 21q, and 22q have been supported by more than one study. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] However, these studies have not identified any specific genes, and a recent metaanalysis of available genome scans showed no regions with a conclusive evidence of linkage. 20 The relatively slow progress of gene-mapping efforts is often explained by the 'complex' nature of the illness and of the genotype-phenotype relation. The complexity most likely includes heterogeneity, interactions of multiple loci, incomplete penetrance, as well as phenotypes resulting from environmental effects-either alone or in interaction with the genetic predisposition. The goal of psychiatric genetic research is identification of (heritable) variations in DNA sequence or function that influence behaviour or give rise to mental illness. By definition, in complex (multifactorial) traits, this link is not unique and specific. That is, a particular change in gene sequence does not necessarily lead to a specific behaviour, and similar behaviours (symptoms) may be due to distinct (sets of) genes. Moreover, we must consider the possibility that the path between the genotype and behaviour is not unidirectional. Emerging examples point not only to general effects of environment, for instance stress, on behaviour, but also to specific behaviours influencing gene function that can be transmitted onto the next generation. 21 No single method is considered clearly superior in identifying susceptibility genes for complex traits such as BD. Most researchers agree that a combination of strategies is most lik...

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Section: Cognitive Endophenotypesmentioning

confidence: 99%

The phenotypes of bipolar disorder: relevance for genetic investigations

2005

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“…Investigators assessed cognitive function, and they found that there was either no change or beneficial effects (i.e., verbal memory, short-term memory, and attention) with the use of novel antipsychotics (Pandina et al, 2007;Troost et al, 2006;Gunther et al, 2006;MacQueen & Young, 2003;Borison, 1996;Meltzer, 1995).…”

Section: Introductionmentioning

confidence: 99%

Effects of risperidone on cognitive-motor performance and motor movements in chronically medicated children

Aman

Hollway

Leone

et al. 2009

Research in Developmental Disabilities

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This study was designed to explore the placebo-controlled effects of risperidone on cognitive-motor processes, dyskinetic movements, and behavior in children receiving maintenance risperidone therapy. Sixteen children aged 4-14 years with disruptive behavior were randomly assigned to drug order in a crossover study of risperidone and placebo for 2 weeks each. Dependent measures included tests of sustained attention, memory, visual matching, tremor, seat activity, abnormal movements, and parent behavior ratings. Results were compared by repeated measures ANOVA Fourteen boys and 2 girls with disruptive behavior and IQ ≤ 84 all completed the protocol. Risperidone was superior to placebo on response time (p = 0.01, η P 2 = 0.43) and seat movement (p < 0.05, η P 2 = 0.29) on a short-term memory task, and on a measure of static tremor (p = 0.05, η P 2 = 0.28). There was not a significant difference between treatment conditions on the Abnormal Involuntary Movement scale. Risperidone was superior to placebo on three subscales of the Nisonger Child Behavior Rating Form [Overly Sensitive (p < 0.01, η P 2 = 0.44), Conduct Problem (p = 0.02, η P 2 = 0.36), Hyperactivity (p = 0.03, η P 2 = 0.32)] and on the Hyperactivity/Noncompliance subscale of the Aberrant Behavior Checklist (p = 0.01, η P 2 = 0.41). Significant increases in heart rate (p = 0.05, η P 2 = 0.27) and weight (p = 0.02, η P 2 = 0.36) occurred in the risperidone condition. The findings suggest a beneficial effect of risperidone after several months of treatment on efficiency of responding, activity level, static tremor, and aspects of behavior.

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“…Some review articles (Van Gorp, Altshuler, Theberge, Wilkins, & Dixon, 1998;Cavanagh, Van Beck, Muir, & Blackwood, 2002;Clark, Iversen, & Goodwin, 2002;Deckersback, McMurrich, Ogutha, Savage, Sachs, & Rauch, 2004) reported consistent deficits in sustained attention, verbal memory, and executive function in mania. Moreover, patients with BD in the depressive or euthymic phase performed better than manic patients in attention tasks (Zubieta, Huguelet, O'Neil, & Giordani, 2001;Clark et al, 2002;Thompson et al, 2005;Xu et al, 2012), verbal learning (Clark et al, 2002;Deckersbach et al, 2004), and visual memory (MacQueen & Young, 2003;Deckersbach et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

“…Lithium has also been shown to exert a neuroprotective effect and be related to better cognitive performance in patients with BD (Bauer, Alda, Priller, & Young, 2003). Atypical antipsychotics have shown more negative effects on cognition compared with lithium and anticonvulsants (Arts, Jabben, Krabbendam, & van Os, 2011;Macqueen, & Young, 2003;Torrent et al, 2011;Yurgelun-Todd et al, 2002).…”

Section: Discussionmentioning

confidence: 99%

Attention impairment in bipolar disorder: A systematic review.

Camelo

Velasques

Ribeiro

et al. 2013

Psychology & Neuroscience

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Bipolar disorder (BD) has been associated with marked cognitive impairment, including euthymic periods. Attention is among the most compromised functions in BD. Changes related to learning, memory, and visuospatial abilities can be derived from these attention impairments. The objective of this article is to review the scientific literature on the performance of BD patients in attention tests. A systematic review was performed of controlled studies that assessed attention in patients diagnosed with BD aged between 18 and 65 years. The databases included Medline, LILACS, Cochrane Library, Institute for Scientific Information Web of Knowledge, and Scientific Electronic Library Online (SciELO), and the search encompassed the period from 2008 to 2013. Only studies that had a minimum sample of 10 patients were included. A total of 110 articles fulfilled the inclusion criteria. Compared with healthy control subjects, bipolar patients showed poorer attention performance. Compared with other mental disorders, BD was associated with poorer performance than unipolar depression but better performance than schizophrenia. When bipolar patients in different phases of the disease were compared with one another, the performance of euthymic patients was similar to or better than patients in a depressive state; moreover, manic patients performed worse than depressive patients. Attention is significantly impaired in BD. Attention impairment in BD is milder than in schizophrenia but greater than in unipolar depression. Attention impairment is possibly more severe in manic and depressed episodes than in euthymic periods

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Cognitive effects of atypical antipsychotics: focus on bipolar spectrum disorders

Cited by 64 publications

References 104 publications

The phenotypes of bipolar disorder: relevance for genetic investigations

The phenotypes of bipolar disorder: relevance for genetic investigations

Effects of risperidone on cognitive-motor performance and motor movements in chronically medicated children

Attention impairment in bipolar disorder: A systematic review.

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