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The switch from conventional to atypical antipsychotic treatment should not be based exclusively on the presence of cognitive deficits. A pilot study in individuals with schizophrenia

DOI: 10.1186/1471-244x-10-47

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Abstract:

In this naturalistic study, we used a comprehensive neuropsychological battery of tests to assess a sample of schizophrenia patients taking either conventional (n = 13) or novel antipsychotics (n = 26) at baseline and at two years after.Continuous antipsychotic treatment regardless of class was associated with improvement on verbal fluency, executive functions, and visual and verbal memory. Patients taking atypical antipsychotics did not show greater cognitive enhancement over two years than patients taking conventional antipsychotics.Although long-term antipsychotic treatment slightly improved cognitive function, the switch from conventional to atypical antipsychotic treatment should not be based exclusively on the presence of these cognitive deficits.Cognitive disturbances are a core feature of schizophrenia and have been extensively studied in recent years [1]. Cognitive impairment is present before the onset of the illness [2] and is also found in healthy relatives of patients, although to a lesser degree [3]. In addition, this feature is not exclusively secondary to psychiatric symptoms or medication [4]. Cognitive impairment is a better predictor of future functional outcomes compared with positive symptoms [5-7].The positive action of conventional antipsychotics drugs (APDs) on cognition is considered mild or moderate [8] and is limited to certain cognitive domains such as sustained attention [9,10].Regarding novel antipsychotics, this supposed cognitive enhancement would be mediated by their capability to raise the level of dopamine and acetylcholine in prefrontal regions [11]. However, their different affinity for brain receptors may result in different procognitive profiles of each class of antipsychotics. Many studies support a cognitive enhancement of the different atypical antipsychotics: quetiapine and olanzapine [12], quetiapine and risperidone [13], ziprasidone and olanzapine [14]; olanzapine, quetiapine, and risperidone [15], risperidone and quetiap

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