Antipsychotic drugs may impair or aid cognition
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Antipsychotic medications used to relieve distress in people with chronic schizophrenia have variable effects on mental functioning and cognitive capability, according to a report sponsored by the National Institute of Medical Health.
“Some patients improve and some get worse, so their doctors need to attend to how an antipsychotic is affecting cognition,” Dr. Richard S. E. Keefe from Duke University Medical Center, Durham, North Carolina told Reuters Health.
Keefe and colleagues in the CATIE study (an acronym for Clinical Antipsychotic Trials of Intervention Effectiveness) compared the effects of five antipsychotic drugs in 817 patients with chronic schizophrenia, focusing on any change in a single composite score for neurocognitive function after 2 months of treatment.
Each of the treatment groups overall showed small improvements in the composite score, the authors report in the Archives of General Psychiatry, and there was no overall difference among the various drugs. However, individual responses varied considerably.
“Some patients in our trial demonstrated great improvements in cognition, and some demonstrated worsening,” Keefe said. “I think that my main points are that the CATIE data show that individual patients need individually tailored antipsychotic choices.”
“Increasingly, cognitive impairment is being viewed as the core of the disorder, and the leading cause of the tremendous disability in schizophrenia,” Keefe commented. “There are no approved treatments for cognitive impairment in schizophrenia, so we need to really focus our energies and resources on developing new ways to treat this most devastating aspect of the disorder.”
SOURCE: Archives of General Psychiatry, June 2007.
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