Risk and efficacy in cognitive functions in Bipolar Disorder II with atypical antipsychotic augmentation

BD-II has been consistently associated with cognitive dysfunction across a broad range of cognitive domains. Atypical antipsychotic drugs, or SGAs are effective antipsychotics in these diseases, often in combination with antidepressants and mood stabilizers. Data on the possible effect of antipsychotics on neuro-cognition are rare and conflicting. The main objective of our study was to assess the effectiveness and possible risks to cognitive function in a group of inpatients affected by BD-II. Forty-five inpatients with Bipolar II Disorder (DSM-5) were included in a two-year observational study. They were treated with sodium valproate as a mood stabiliser, atypical antipsychotics and SSRIs. The utilized SGA augmentation were quetiapine (n=13); aripiprazole (n=10); olanzapine (n=11); asenapine (n=11). All inpatients were administered some psychopathological scales and evaluated for neuropsychological variables (for example, attention, verbal memory domains, etc.). After two years of treatment with SGAs, there has been no significant reduction of previous levels. In particularly, quetiapine and asenapine groups showed a better performance in learning task, short-term task and recognition tasks, in accordance with previous studies. Our small observational study shown that atypical antipsychotics cause an improvement in symptoms in BD, and particularly BD II. In particular, they do not induce significant alterations in overall cognitive performance generally. On the contrary, some SGAs, such as quetiapine and asenapine, seem to demonstrate a not statistically significant mild improvement in cognition.