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Cognitive effectiveness of olanzapine and risperidone in first-episode psychosis.

Author(s): Cuesta MJ, Jalon EG, Campos MS, Peralta V

Affiliation(s): Psychiatric Unit, Virgen del Camino Hospital c/Irunlarrea 4, Pamplona E-31008, Spain. mcuestaz@cfnavarra.es

Publication date & source: 2009-05, Br J Psychiatry., 194(5):439-45.

Publication type: Randomized Controlled Trial; Research Support, Non-U.S. Gov't

BACKGROUND: Cognitive impairment in schizophrenia-spectrum disorders is highly prevalent and notably influences functional outcomes. AIMS: To characterise the cognitive effectiveness of second-generation antipsychotic drugs. METHOD: One hundred consecutive and previously unmedicated patients with first-episode schizophrenia-spectrum disorders were admitted. Seventy-seven completed baseline, 1-month and 6-month psychopathological and neuropsychological assessments. Patients were randomised to risperidone or olanzapine treatment. Four final treatment allocation groups were defined since patients continued treatment in their normal setting: risperidone, olanzapine, mixed and no-antipsychotic groups. RESULTS: There were no differences in cognitive effectiveness between the four treatment groups. Reliable change index methods demonstrated that nearly a half of patients showed an improvement in Global Cognitive Score at the 6-month assessment. Improvement on the neuropsychological tests ranged from 17 to 54%. A strong predictor of cognitive response was poor performance on baseline neuropsychological tests; response was moderately influenced by a low premorbid scholastic performance and IQ. CONCLUSIONS: Cognitive improvement related to second-generation antipsychotic drugs appeared within the first 4 weeks of treatment and persisted at 6 months irrespective of treatment group. Greater cognitive dysfunction at baseline and lower premorbid cognitive background predicted cognitive improvement in our sample.

Page last updated: 2009-10-20

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