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Title: CPA: Rivastigmine Tartrate May Reduce Cognitive Deficits in Patients with Schizophrenia
URL: http://www.pslgroup.com/dg/20E1D2.htm
Doctor's Guide
November 20, 2001


By Louise Gagnon
Special to DG News

MONTREAL, QC -- November 20, 2001 -- An acetylcholinase inhibitor can be used to treat cognitive deficits in schizophrenics.

The finding from a small study was presented yesterday (Nov. 19) at the annual scientific meeting of the Canadian Psychiatric Association, in Montreal, Quebec, Canada.

"Cognitive deficits are a major problem in schizophrenia," said Dr. M. A. Hussain, the study's principal investigator and chief psychiatrist at Prince Albert Mental Health Centre and assistant professor with the department of psychiatry, University of Saskatchewan, in Regina, Saskatchewan, Canada. "Patients are symptom free, but they still are not functioning and cannot live independently."

Similar to research done in Alzheimer's disease, the study's investigators postulated that cognitive deterioration is related to deficits in central cholinergic function. Acetylcholinesterase inhibitors should produce similar improvement in schizophrenia, as they do in Alzheimer's, by mediating the effects of clozapine. The obstacle to the subjects functioning autonomously is difficulties in cognition, according to Dr. Hussain.

"If we can neutralize the anticholinergic activity of clozapine therapy, it will have a positive impact on cognition," Dr. Hussain said.

Three men and nine women with schizophrenia who were being treated with clozapine and who exhibited neurocognitive deficits were treated with rivastigmine tartrate 3-6 mg per day. The mean age of patients was 38 years, with the range being 22 to 54. Two patients discontinued therapy due to gastrointestinal side effects.

Researchers used the Trail Making Test and the Wechsler Adult Intelligence Scale - III Scores to assess changes in cognition with the drug therapy. The tests examine abstract reasoning, executive function, and working memory. Seven patients showed significant improvement in their cognitive functions and the other three showed moderate improvement. Eight reported an improvement in personal hygiene and appearance and in quality of life. Two found gainful employment.

"The patients become stable with clozapine therapy, but they may not be looking after themselves if they are left alone," Dr. Hussain said. "They forget about their hygiene. They usually have to live in group homes. The treatment has allowed some to get jobs and go back to school."

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