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First- and second-generation antipsychotic medication and cognitive processing in schizophrenia.
Thomas W Weickert1, Terry E Goldberg
1Clinical Brain Disorders Branch, Genes, Cognition, and Psychosis Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA.
Current Psychiatry Reports
|August 16, 2005
Summary
Schizophrenia patients often experience cognitive deficits. Antipsychotic medications, particularly those targeting dopamine D2 receptors, can improve cognitive functions like working memory, with genetic factors influencing treatment response.
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Schizophrenia is marked by cognitive impairments in executive function, working memory, attention, and episodic memory.
- While some motor slowing may be drug-induced, cognitive deficits are largely attributed to the disease process itself.
Purpose of the Study:
- To explore the impact of antipsychotic medication on cognitive deficits in schizophrenia.
- To investigate the role of dopamine modulation and genetic factors in medication-induced cognitive improvements.
Main Methods:
- Review of studies on antipsychotic medication effects on cognition in schizophrenia.
- Focus on dopamine D2 receptor blockade and its association with cognitive performance.
- Examination of genetic polymorphisms, specifically COMT val108/158met, and their interaction with treatment.
Main Results:
- Dopamine modulation, via D2 receptor blockade, is linked to reduced psychotic symptoms and enhanced cognition in schizophrenia.
- Both first-generation and second-generation antipsychotics show cognitive benefits, with second-generation drugs potentially offering greater improvements.
- The catechol-O-methyltransferase (COMT) val108/158met polymorphism predicts working memory improvement in response to antipsychotic treatment.
Conclusions:
- Antipsychotic medication can improve cognitive processing in schizophrenia, potentially by enhancing general cortical information processing.
- Genetic variations, such as the COMT polymorphism, play a crucial role in individualizing treatment response and predicting cognitive gains.
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