[Tolerance of neuroleptics, deficit syndrome and cognitive functions]

Neuroleptics have been held responsible for cognitive impairments and negative symptoms in the course of schizophrenia. On the other hand, recent data suggest that alterations in information processing, cognitive and neuro-psychological functions are present at early stages in the developmental course of the illness. Two recent reviews, by D. King and G. Cassens suggest that, although acute administration of neuroleptics may alter performances in some neuro-psychological functions, there is no convincing evidence so far, to support a significant role of chronic neuroleptic treatment in the development of negative symptoms and cognitive dysfunction in schizophrenia. Despite several methodological limitations, which preclude any definitive statement, experimental and clinical data suggest that chronic neuroleptic treatment might improve neuropsychological functioning and the deficit syndrome, in some groups of schizophrenic patients. These results are examined in the framework of recent theoretical developments, which emphasize the role of cognitive dysfunction in the pathophysiology of schizophrenia.