By Judith Moser, MD
BARCELONA, Spain -- September 3, 2008 -- In patients with chronic schizophrenia, the type of antipsychotic treatment (typical or atypical) is not as important for long-term cognitive and social functioning, according to the results of a study presented here at the 21st European College of Neuropsychopharmacology Congress (ECNP).
Research in the field of neuropsychopharmacology has been indicating a beneficial influence of atypical antipsychotic treatment on cognitive function of patients with schizophrenia, but there have been contradictory findings as well.
"In our study, we compared the patients' functioning with their present medication," explained Agnieszka Kalwa, PhD student, Independent Pharmacotherapy Unit, Institute of Psychiatry and Neurology, Warsaw, Poland, at a poster presentation on September 2.
The study assessed the relationship between the type of current antipsychotic therapy and the cognitive, clinical, and global social outcome in 30 patients with a duration of disease ranging from 29 to 36 years.
The current antipsychotic treatment duration was at least 6 months, and all patients were remitted at the time of the study.
Eighteen received typical antipsychotics (zuclopentixol, perphenazine, perazine, levomepromazine, fluspirilen, and haloperidol). Twelve patients were treated with atypical antipsychotics (olanzapine, clozapine, risperidone, and quetiapine).
For neuropsychological assessment, the researchers assess executive function using the Wisconsin Card Sorting Test, psychomotor speed using the Trial Making Test, visuospatial working memory and shifting abilities, verbal working memory using the Stroop Test, and verbal functioning using the Verbal Fluency Test.
The Brief Psychiatric Rating Scale, the Clinical Global Impairment scale, and the Global Assessment Scale were used to measure the intensity of symptoms, severity of disease, and social global functioning.
"We found no difference [in outcomes] between patients treated with typical and atypical antipsychotics," Kalwa said.
The Mann-Whitney U test detected no significant in-group difference between the type of antipsychotic treatment and the results of the neuropsychological tests.
The only indicator of worse cognitive function in patients treated with typical antipsychotics was a higher number of perseverations in the Verbal Fluency Test. Nevertheless, the long illness duration must be taken into consideration. "Many of the patients had a very long history of typical antipsychotic treatment," Kalwa said.
When the researchers compared the current findings with follow-up results in the same patients from the time after onset of the disease, they found that cognitive functioning is related to the course of the disease and to the previous and present global social adjustment, rather than to the type of pharmacological treatment.
"For example, effectiveness of thinking was connected with a systematic pharmacological treatment during the first 9 years," Kalwa said.
[Presentation title: Cognitive Function and Antipsychotic Treatment in Chronic Schizophrenia. Abstract 3c006]
E-Mail this DGDispatch to a colleague
