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Cognitive effectiveness of olanzapine and risperidone in first-episode psychosis
Manuel J Cuesta1, Elena Garcíade Jalón, M Soledad Campos
1Psychiatric Unit, Virgen del Camino Hospital c/Irunlarrea 4, Pamplona E-31008, Spain. mcuestaz@cfnavarra.es
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.
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