Short term neurocognitive effects of treatment with ziprasidone and olanzapine in recent onset schizophrenia
Received 21 October 2009; received in revised form 19 April 2010; accepted 26 April 2010. published online 21 May 2010.
Abstract
Background
Cognitive deficits are a core feature in schizophrenia. Cognitive deficits appear to be present at the onset of schizophrenia and persist after remission of psychotic symptoms. As cognitive deficits are associated with poor functional outcome, they form an important focus of treatment. There are relatively few head-to-head comparisons of the effects of second generation antipsychotics on cognition in recent onset schizophrenia. This is the first study to compare the effects of a short term treatment of olanzapine versus ziprasidone on cognitive functioning in recent onset schizophrenia. An earlier study conducted in chronic patients revealed an enhancement of cognition after treatment for both agents, but the extent of improvement was not significantly different between ziprasidone and olanzapine.
Method
Patients with recent onset schizophrenia with limited previous exposure to medical treatment underwent a double blind randomized controlled treatment trial. Fifty-six patients completed the neuropsychological testing procedure prior to randomization and after eight weeks of treatment and were included in the analysis. We tested cognitive functioning in general and verbal memory in particular. We calculated a single unweighted composite score based on nine cognitive tests to determine general cognitive functioning.
Results
Cognition appeared enhanced after treatment, but was not significantly different between treatment groups, neither for the verbal memory measures, nor for the neurocognitive composite score. Furthermore, cognitive enhancement did not correlate to clinical improvement.
Conclusion
Cognitive deficits are not a reason for preferentially prescribing one of the two second generation antipsychotics tested over the other.
aRudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
bRadboud University Medical Center, Nijmegen, The Netherlands
cUniversity Psychiatric Center, Catholic University of Leuven, campus Kortenberg, Belgium
dCollaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Belgium
eCenter of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, Tilburg, The Netherlands
Corresponding author. Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical Center Utrecht, Room A.00.241, P.O. Box 85500, NL-3508 GA Utrecht, The Netherlands. Tel.: +31 88 7558180; fax: +31 88 7555443.
1 Currently at CWZ Hospital Nijmegen, The Netherlands.
ABSTRACT