The effects of second-generation antipsychotics on cognitive functioning and psychosocial outcome in schizophrenia

Abstract

Neuropsychological deficits seem to be a major predictor of psychosocial outcome in patients with schizophrenia. Second-generation antipsychotics have shown greater promise in treating neuropsychological deficits than conventional antipsychotic drugs. This article summarizes the effect of newer antipsychotics on cognitive functioning and the implications for functional outcome. In this context it also addresses several methodological and conceptional issues that limited the comparison of these studies.

Cognitive Improvement in Schizophrenic Patients does not Require a Serotonergic Mechanism: Randomized Controlled Trial of Olanzapine vs Amisulpride

“…A randomized clinical trial of Purdon et al (2000) compared cognitive effects of haloperidol with two SGAs (olanzapine and risperidone) over 12 months and found olanzapine to be superior to risperidone and haloperidol in a global cognitive measure, with few reliable treatment differences for single tests or cognitive domains. This study has been criticized for high dropout rates, which were different between treatments (Weiss et al, 2002), and for a high average dosage of risperidone (Sharma, 2002). A subsequent 14-week study by Bilder et al (2002) confirmed that 10-40 mg olanzapine was superior to 10-30 mg haloperidol (particularly with regard to attention), but also found improvements in memory, which were most marked for 4-16 mg risperidone, implicating that different SGAs may differ in their patterns of cognitive effects.…”

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia, Part 2: Long-term treatment of schizophrenia

“…This could be confirmed for some cognitive domains in a randomised doubleblind study comparing olanzapine, risperidone, clozapine and haloperidol in patients with a history of suboptimal response to conventional antipsychotics . A systematic review showed superior beneficial effects on neurocognition in patients treated with SGAs (clozapine, risperidone, olanzapine, quetiapine and zotepine) compared to FGAs, although some studies provided conflicting results and there was a variety of methodological limitations (Weiss et al 2002). In addition, a randomised double-blind study demonstrated comparable cognitive-enhancing effects relative to previous treatment (mostly haloperidol or risperidone) in acutely ill inpatients treated with olanzapine or ziprasidone (Harvey et al 2004).…”

Cognitive Impairment Associated with Schizophrenia: A Review of the Humanistic Burden

“…• Washing [56,60] • Dressing [56,60] • Cooking [56,60] • Shopping [18,60] • Self care [56,60] • Independent living [18,60] Relationships [41,67] • Care-giver [38] • Partner/intimate [41,56,67] • Social [41,67] • Family [41,67] • Friends [41,67] Social functioning [16,34,43,61] • Social skills [18] • Social reintegration [38] • Social leisure [39,40] Occupational functioning [27,37,42,51] • Unemployment [16,40] • Hours of employment [15] • Number of days worked [65,66] Cognitive symptoms [35,38,43,45] • Weight gain [35,38,43,…”