Relationships between changes in symptom ratings, neuropsychological test performance and quality of life in schizophrenic patients treated with clozapine

Galletly, Cherrie; Clark, Christopher; McFarlane, Alexander C.; Weber, Darren L.

doi:10.1016/s0165-1781(97)00062-0

Cited by 96 publications

(62 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Some studies have demonstrated improvement in simple working memory performance following atypical antipsychotic administration (Galletly et al, 1997;Green et al, 1997;Rossi et al, 1997); however, our study found no difference on WMS-R digit span forward between patients receiving antipsychotic medication and the same patients receiving placebo. Our study is also consistent with many studies that have shown improvement on measures of language production (letter and category fluency) following atypical antipsychotic administration (Buchanan et al, 1994;Galletly et al, 1997;Hagger et al, 1993;Hoff et al, 1996;Lee et al, 1994;Potkin et al, 2001). Also, our findings are consistent with two studies that show improvement in overall intellectual abilities (Fujii et al, 1997;Potkin et al, 2001).…”

Section: Discussioncontrasting

confidence: 86%

Comparison of Cognitive Performances During a Placebo Period and an Atypical Antipsychotic Treatment Period in Schizophrenia: Critical Examination of Confounds

Weickert

Goldberg

Marenco

et al. 2003

Neuropsychopharmacol

View full text Add to dashboard Cite

Although previous studies report cognitive improvement following atypical antipsychotic administration in schizophrenia (SC), few placebo-controlled within-subject studies with examination of confounds (symptom reduction, cooperation, learning, and outliers) have been reported. The present study examines the effects of atypicals and confounds upon cognition in SC. The hypothesis tested was that relative to placebo, atypicals as a general class of medication would elicit cognitive improvement in SC. In all, 19 patients with SC (15 males) completed the double-blind, counterbalanced, randomized within-subject study of the effects of atypical antipsychotics (risperidone, clozapine, olanzapine, or quetiapine) vs placebo administration upon cognitive performance in the domains of executive function, attention, memory, language, visual perception, and general intellect. Significant cognitive improvement during atypical antipsychotic administration relative to placebo withdrawal occurred in most cognitive domains with robust improvements in intelligence (p ¼ 0.001), memory (p ¼ 0.0009), and fluency (po0.002) even after outliers and unmotivated performances were excluded. These findings suggest that relative to placebo withdrawal, atypicals improve cognitive performance in SC. However, this finding may not be specific to atypicals, since analogous studies of typicals have not been performed.

show abstract

Section: Discussioncontrasting

confidence: 86%

Comparison of Cognitive Performances During a Placebo Period and an Atypical Antipsychotic Treatment Period in Schizophrenia: Critical Examination of Confounds

Weickert

Goldberg

Marenco

et al. 2003

Neuropsychopharmacol

View full text Add to dashboard Cite

show abstract

“…Impairment was observed in patients' rela-dominance of symptoms related to anxiety and depression. Similar results also have been observed in other studies 18,32 . It is estimated that 2%-45% of the homeless suffer from schizophrenia 33 .…”

Section: Discussionsupporting

confidence: 93%

Quality of life assessment of patients with schizophrenic spectrum disorders from Psychosocial Care Centers

Silva

Mason

Abelha

et al. 2011

J. bras. psiquiatr.

View full text Add to dashboard Cite

rESUMo objetivo: Avaliar a qualidade de vida e as características sociodemográficas e clínicas associadas em amostra de pacientes com transtorno do espectro esquizofrênico (CID-10 F20--F29) atendidos nos CAPS da área programática 3.0 da cidade do Rio de Janeiro. Métodos: Realizou-se estudo transversal em amostra de pacientes com diagnóstico pertencente ao espectro esquizofrênico, matriculados em 2008 nos CAPS da AP 3 da cidade do Rio de Janeiro. Foram utilizados instrumentos semiestruturados na avaliação da esquizofrenia e uso de álcool e drogas (MINIPLUS), sintomas psiquiátricos (PANSS) e qualidade de vida (QLS-BR). resultados: Foram entrevistados 79 pacientes, dos quais 74 (93,7%) tinham algum prejuízo na qualidade de vida. A área mais afetada foi o nível ocupacional. As variáveis que se mostraram significativamente associadas ao grave comprometimento da qualidade de vida foram: estado civil, raça, ocupação, com quem reside, situação de rua, ter filhos, internação psiquiátrica prévia, tipo sintomatológico negativo e não aplicável (sendo este caracterizado pela escassez dos típicos sintomas positivos e negativos). Conclusão: O conhecimento desses fatores é importante para a formulação de políticas de saúde e programas de reabilitação psicossocial voltados para a otimização da qualidade de vida dessa clientela.

show abstract

“…Several open-label and double-blind studies comparing clozapine to traditional antipsychotic with neurocognitive batteries have reported, almost unanimously, an improvement in verbal memory, visual attention, and verbal fluency with clozapine (Goldberg et al, 1993;Hagger et al, 1993;Buchanan et al, 1994;Grace et al, 1996;Hoff et al, 1996;Galletly et al, 1997). The gains, however, were modest and some negative effect, in visual memory for example, was noted as well (Goldberg and Weinberger, 1994).…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, in addition, it is not associated with Parkinsonism, akathisia, or tardive dyskinesia, and may improve cognitive function in schizophrenia (Buchanan and McKenna, 2000). When detected, clozapine-induced cognitive gains are modest and limited to discrete measures, including verbal fluency, verbal memory, and attention (Goldberg et al, 1993;Hagger et al, 1993;Buchanan et al, 1994;Grace et al, 1996;Hoff et al, 1996;Galletly et al, 1997). Some aspects of clozapine's action on cognitive function, which form the basis for its long-term psychosocial benefits, may yet have to be quantified.…”

Section: Introductionmentioning

confidence: 99%

“…Some aspects of clozapine's action on cognitive function, which form the basis for its long-term psychosocial benefits, may yet have to be quantified. These long-term psychosocial improvements occur in domains as diverse as quality of life (Galletly et al, 1997;Meltzer et al, 1990), compliance and treatment participation (Rosenheck et al, 1997;Luchins et al, 1998), violent behavior (Buchanan et al, 1998;Glazer and Dickson, 1998;Frankle et al, 2001), and substance abuse (Buckley et al, 1994). The mechanism of clozapine's unique antipsychotic efficacy is not known, but along with its benign motor effect profile, the clinical actions balance the significant agranulocytosis risk of the drug (Alvir et al, 1993).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clozapine but not Haloperidol Re-establishes Normal Task-Activated rCBF Patterns in Schizophrenia within the Anterior Cingulate Cortex

Lahti

Holcomb

Weiler

et al. 2003

Neuropsychopharmacol

View full text Add to dashboard Cite

Our previous work has identified that unmedicated volunteers with schizophrenia have regional cerebral blood flow (rCBF) activation patterns inappropriately related to the cognitive demand of a task in anterior cingulate cortex (ACC). Using positron emission tomography (PET) with 15 O water, we compared task-induced rCBF patterns induced by haloperidol or clozapine in individuals with schizophrenia. We hypothesized that clozapine, given its superior clinical action, would tend to normalize the abnormal task-activated response in ACC more than haloperidol. Schizophrenia volunteers (SVs) (n ¼ 6) and normal volunteers (NVs) (n ¼ 12) were trained to perform a tone discrimination task with 70-80% accuracy. They were then scanned during three task conditions: (1) Rest, (2) sensory motor control (SMC) task, and (3) decision task (DEC). SVs were initially scanned after withdrawal of all psychotropic medication and again after treatment with therapeutic doses of haloperidol (n ¼ 5) and/or clozapine (n ¼ 5). rCBF values, sampled in the grown maxima of the task-activated ACC cluster, were analyzed between groups and task conditions. Task performance was similar across the unmedicated, haloperidol-and clozapine-medicated SV groups. There was a reduction in accuracy in the haloperidol SV group compared to the NVs. Group and task conditions affected rCBF in the ACC. Clozapine, but not haloperidol, reversed the abnormal ACC rCBF pattern in unmedicated SV to normal. The clozapine-treated SV group showed a rCBF pattern similar to the NV group in that ACC activation was not observed during the control task but occurred during the decision condition. The pattern seen in the haloperidoltreated SV group was similar to the unmedicated SV group in that ACC activation was seen during the control task and no further activation was seen during the DEC. We report that clozapine, but not haloperidol, normalizes anterior cingulate rCBF patterns in schizophrenia during a cognitive task. Based on these preliminary data, we propose that this pattern may account for the superior therapeutic effect of clozapine and represents a surrogate marker of this action.

show abstract

Relationships between changes in symptom ratings, neuropsychological test performance and quality of life in schizophrenic patients treated with clozapine

Cited by 96 publications

References 25 publications

Comparison of Cognitive Performances During a Placebo Period and an Atypical Antipsychotic Treatment Period in Schizophrenia: Critical Examination of Confounds

Comparison of Cognitive Performances During a Placebo Period and an Atypical Antipsychotic Treatment Period in Schizophrenia: Critical Examination of Confounds

Quality of life assessment of patients with schizophrenic spectrum disorders from Psychosocial Care Centers

Clozapine but not Haloperidol Re-establishes Normal Task-Activated rCBF Patterns in Schizophrenia within the Anterior Cingulate Cortex

Contact Info

Product

Resources

About