Am J Psychiatry 159:1018-1028, June 2002
© 2002 American Psychiatric Association
Neurocognitive Effects of Clozapine, Olanzapine, Risperidone, and Haloperidol in Patients With Chronic Schizophrenia or Schizoaffective Disorder
Robert M. Bilder, Ph.D.,
Robert S. Goldman, Ph.D.,
Jan Volavka, M.D, Ph.D.,
Pal Czobor, Ph.D.,
Matthew Hoptman, Ph.D.,
Brian Sheitman, M.D.,
Jean-Pierre Lindenmayer, M.D.,
Leslie Citrome, M.D., M.P.H.,
Joseph McEvoy, M.D.,
Michal Kunz, M.D.,
Miranda Chakos, M.D.,
Thomas B. Cooper, M.A.,
Terri L. Horowitz, Ph.D., and
Jeffrey A. Lieberman, M.D.
OBJECTIVE: Newer antipsychotic drugs have shown promise in ameliorating neurocognitive deficits in patients with schizophrenia, but few studies have compared newer antipsychotic drugs with both clozapine and conventional agents, particularly in patients who have had suboptimal response to prior treatments. METHOD: The authors examined the effects of clozapine, olanzapine, risperidone, and haloperidol on 16 measures of neurocognitive functioning in a double-blind, 14-week trial involving 101 patients. A global score was computed along with scores in four neurocognitive domains: memory, attention, motor function, and general executive and perceptual organization. RESULTS: Global neurocognitive function improved with olanzapine and risperidone treatment, and these improvements were superior to those seen with haloperidol. Patients treated with olanzapine exhibited improvement in the general and attention domains but not more than that observed with other treatments. Patients treated with risperidone exhibited improvement in memory that was superior to that of both clozapine and haloperidol. Clozapine yielded improvement in motor function but not more than in other groups. Average effect sizes for change were in the small to medium range. More than half of the patients treated with olanzapine and risperidone experienced "clinically significant" improvement (changes in score of at least one-half standard deviation relative to baseline). These findings did not appear to be mediated by changes in symptoms, side effects, or blood levels of medications. CONCLUSIONS: Patients with a history of suboptimal response to conventional treatments may show cognitive benefits from newer antipsychotic drugs, and there may be differences between atypical antipsychotic drugs in their patterns of cognitive effects.
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Schizophr Bull,
September 23, 2009;
(2009)
sbp095v1.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. Bergemann, P. Parzer, S. Jaggy, B. Auler, C. Mundt, and S. Maier-Braunleder
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Schizophr Bull,
November 1, 2008;
34(6):
1172 - 1181.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. K. Hill, J. L. Reilly, M. S. H. Harris, T. Khine, and J. A. Sweeney
Oculomotor and Neuropsychological Effects of Antipsychotic Treatment for Schizophrenia
Schizophr Bull,
May 1, 2008;
34(3):
494 - 506.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Szoke, A. Trandafir, M.-E. Dupont, A. Meary, F. Schurhoff, and M. Leboyer
Longitudinal studies of cognition in schizophrenia: meta-analysis
The British Journal of Psychiatry,
April 1, 2008;
192(4):
248 - 257.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. S. Stone and L. J. Seidman
Toward a Model of Memory Enhancement in Schizophrenia: Glucose Administration and Hippocampal Function
Schizophr Bull,
January 1, 2008;
34(1):
93 - 108.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. O. Brooks and J. C. Hoblyn
Neurocognitive Costs and Benefits of Psychotropic Medications in Older Adults
J Geriatr Psychiatry Neurol,
December 1, 2007;
20(4):
199 - 214.
[Abstract]
[PDF]
|
|
|
|
|
|
|
M. J. Sergi, M. F. Green, C. Widmark, C. Reist, S. Erhart, D. L. Braff, K. S. Kee, S. R. Marder, and J. Mintz
Social Cognition and Neurocognition: Effects of Risperidone, Olanzapine, and Haloperidol
Am J Psychiatry,
October 1, 2007;
164(10):
1585 - 1592.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. E. Goldberg, R. S. Goldman, K. E. Burdick, A. K. Malhotra, T. Lencz, R. C. Patel, M. G. Woerner, N. R. Schooler, J. M. Kane, and D. G. Robinson
Cognitive Improvement After Treatment With Second-Generation Antipsychotic Medications in First-Episode Schizophrenia: Is It a Practice Effect?
Arch Gen Psychiatry,
October 1, 2007;
64(10):
1115 - 1122.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. A. Gray and B. L. Roth
Molecular Targets for Treating Cognitive Dysfunction in Schizophrenia
Schizophr Bull,
September 1, 2007;
33(5):
1100 - 1119.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. S.E. Keefe, J. A. Sweeney, H. Gu, R. M. Hamer, D. O. Perkins, J. P. McEvoy, and J. A. Lieberman
Effects of Olanzapine, Quetiapine, and Risperidone on Neurocognitive Function in Early Psychosis: A Randomized, Double-Blind 52-Week Comparison
Am J Psychiatry,
July 1, 2007;
164(7):
1061 - 1071.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Morrens, W. Hulstijn, and B. Sabbe
Psychomotor Slowing in Schizophrenia
Schizophr Bull,
July 1, 2007;
33(4):
1038 - 1053.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. K. Erickson, J. R. Ciccone, S. B. Schwarzkopf, J. S. Lamberti, and M. J. Vitacco
Legal Fallacies of Antipsychotic Drugs
J Am Acad Psychiatry Law,
June 1, 2007;
35(2):
235 - 246.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. S. E. Keefe, R. M. Bilder, S. M. Davis, P. D. Harvey, B. W. Palmer, J. M. Gold, H. Y. Meltzer, M. F. Green, G. Capuano, T. S. Stroup, et al.
Neurocognitive Effects of Antipsychotic Medications in Patients With Chronic Schizophrenia in the CATIE Trial
Arch Gen Psychiatry,
June 1, 2007;
64(6):
633 - 647.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
References
PsychiatryOnline CME,
May 1, 2007;
2007(1):
2 - 2.
[Full Text]
|
|
|
|
|
|
|
J. M. Noel
ASHP Therapeutic Position Statement on the Use of Second-Generation Antipsychotic Medications in the Treatment of Adults with Psychotic Disorders
Am. J. Health Syst. Pharm.,
April 15, 2007;
64(8):
863 - 876.
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. D. Harvey, C. R. Bowie, and A. Loebel
Neuropsychological Normalization With Long-Term Atypical Antipsychotic Treatment: Results of a Six-Month Randomized, Double-Blind Comparison of Ziprasidone vs. Olanzapine.
J Neuropsychiatry Clin Neurosci,
December 1, 2006;
18(1):
54 - 63.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Burton
Symptom domains of schizophrenia: the role of atypical antipsychotic agents
J Psychopharmacol,
November 1, 2006;
20(6_suppl):
6 - 19.
[Abstract]
[PDF]
|
|
|
|
|
|
|
E. Kim and M. Bijlani
A Pilot Study of Quetiapine Treatment of Aggression Due to Traumatic Brain Injury
J Neuropsychiatry Clin Neurosci,
November 1, 2006;
18(4):
547 - 549.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. S Turner and D. W Stewart
Review of the evidence for the long-term efficacy of atypical antipsychotic agents in the treatment of patients with schizophrenia and related psychoses
J Psychopharmacol,
November 1, 2006;
20(6_suppl):
20 - 37.
[Abstract]
[PDF]
|
|
|
|
|
|
|
P. Chue
The relationship between patient satisfaction and treatment outcomes in schizophrenia
J Psychopharmacol,
November 1, 2006;
20(6_suppl):
38 - 56.
[Abstract]
[PDF]
|
|
|
|
|
|
|
H. A. Nasrallah and R. Lasser
Improving patient outcomes in schizophrenia: achieving remission
J Psychopharmacol,
November 1, 2006;
20(6_suppl):
57 - 61.
[Abstract]
[PDF]
|
|
|
|
|
|
|
U. S. KOLUR, Y.C.J. REDDY, J.P. JOHN, T. KANDAVEL, and S. JAIN
Sustained attention and executive functions in euthymic young people with bipolar disorder
The British Journal of Psychiatry,
November 1, 2006;
189(5):
453 - 458.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Naudts and S. Hodgins
Neurobiological Correlates of Violent Behavior Among Persons With Schizophrenia
Schizophr Bull,
July 1, 2006;
32(3):
562 - 572.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Olincy, J. G. Harris, L. L. Johnson, V. Pender, S. Kongs, D. Allensworth, J. Ellis, G. O. Zerbe, S. Leonard, K. E. Stevens, et al.
Proof-of-Concept Trial of an {alpha}7 Nicotinic Agonist in Schizophrenia.
Arch Gen Psychiatry,
June 1, 2006;
63(6):
630 - 638.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. M. Haddad and S. Dursun
Selecting antipsychotics in schizophrenia: lessons from CATIE
J Psychopharmacol,
May 1, 2006;
20(3):
332 - 334.
[PDF]
|
|
|
|
|
|
|
A. E. Thornton, J. X. Van Snellenberg, A. A. Sepehry, and W. G. Honer
The impact of atypical antipsychotic medications on long-term memory dysfunction in schizophrenia spectrum disorder: a quantitative review
J Psychopharmacol,
May 1, 2006;
20(3):
335 - 346.
[Abstract]
[PDF]
|
|
|
|
|
|
|
P. A Marken and R. W Pies
Emerging Treatments for Bipolar Disorder: Safety and Adverse Effect Profiles
Ann. Pharmacother.,
February 1, 2006;
40(2):
276 - 285.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. J. Weiden
Switching antipsychotics: an updated review with a focus on quetiapine
J Psychopharmacol,
January 1, 2006;
20(1):
104 - 118.
[Abstract]
[PDF]
|
|
|
|
|
|
|
K. Rasmussen, M. J. Benvenga, F. P. Bymaster, D. O. Calligaro, I. R. Cohen, J. F. Falcone, S. K. Hemrick-Luecke, F. M. Martin, N. A. Moore, L. K. Nisenbaum, et al.
Preclinical Pharmacology of FMPD [6-Fluoro-10-[3-(2-methoxyethyl)-4-methyl-piperazin-1-yl]-2-methyl-4H-3-thia-4,9-diaza-benzo[f]azulene]: A Potential Novel Antipsychotic with Lower Histamine H1 Receptor Affinity Than Olanzapine
J. Pharmacol. Exp. Ther.,
December 1, 2005;
315(3):
1265 - 1277.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. VEVERA, A. HUBBARD, A. VESELY, and H. PAPEZOVA
Violent behaviour in schizophrenia: Retrospective study of four independent samples from Prague, 1949 to 2000
The British Journal of Psychiatry,
November 1, 2005;
187(5):
426 - 430.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. D. Harvey, J. Rabinowitz, M. Eerdekens, and M. Davidson
Treatment of Cognitive Impairment in Early Psychosis: A Comparison of Risperidone and Haloperidol in a Large Long-Term Trial
Am J Psychiatry,
October 1, 2005;
162(10):
1888 - 1895.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Freedman
The Choice of Antipsychotic Drugs for Schizophrenia
N. Engl. J. Med.,
September 22, 2005;
353(12):
1286 - 1288.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. S. KESHAVAN, G. BERGER, R. B. ZIPURSKY, S. J. WOOD, and C. PANTELIS
Neurobiology of early psychosis
The British Journal of Psychiatry,
August 1, 2005;
187(48):
s8 - s18.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. M. Gardner, R. J. Baldessarini, and P. Waraich
Modern antipsychotic drugs: a critical overview
Can. Med. Assoc. J.,
June 21, 2005;
172(13):
1703 - 1711.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. R. McGurk, C. Carter, R. Goldman, M. F. Green, S. R. Marder, H. Xie, N. R. Schooler, and J. M. Kane
The Effects of Clozapine and Risperidone on Spatial Working Memory in Schizophrenia
Am J Psychiatry,
May 1, 2005;
162(5):
1013 - 1016.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. W Buchanan, M. Davis, D. Goff, M. F Green, R. S E Keefe, A. C Leon, K. H Nuechterlein, T. Laughren, R. Levin, E. Stover, et al.
A Summary of the FDA-NIMH-MATRICS Workshop on Clinical Trial Design for Neurocognitive Drugs for Schizophrenia
Schizophr Bull,
January 1, 2005;
31(1):
5 - 19.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Citrome and J. Volavka
Consensus Development Conference on Antipsychotic Drugs and Obesity and Diabetes: Response to consensus statement
Diabetes Care,
August 1, 2004;
27(8):
2087 - 2088.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. S.E. Keefe, L. J. Seidman, B. K. Christensen, R. M. Hamer, T. Sharma, M. M. Sitskoorn, R. R.J. Lewine, D. A. Yurgelun-Todd, R. C. Gur, M. Tohen, et al.
Comparative Effect of Atypical and Conventional Antipsychotic Drugs on Neurocognition in First-Episode Psychosis: A Randomized, Double-Blind Trial of Olanzapine Versus Low Doses of Haloperidol
Am J Psychiatry,
June 1, 2004;
161(6):
985 - 995.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. H. Mathalon, T. Heinks, and J. M. Ford
Selective Attention in Schizophrenia: Sparing and Loss of Executive Control
Am J Psychiatry,
May 1, 2004;
161(5):
872 - 881.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Martinez-Aran, E. Vieta, M. Reinares, F. Colom, C. Torrent, J. Sanchez-Moreno, A. Benabarre, J. M. Goikolea, M. Comes, and M. Salamero
Cognitive Function Across Manic or Hypomanic, Depressed, and Euthymic States in Bipolar Disorder
Am J Psychiatry,
February 1, 2004;
161(2):
262 - 270.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. M. Lafayette, W. G. Frankle, A. Pollock, K. Dyer, and D. C. Goff
Clinical Characteristics, Cognitive Functioning, and Criminal Histories of Outpatients With Schizophrenia
Psychiatr Serv,
December 1, 2003;
54(12):
1635 - 1640.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Freedman
Schizophrenia
N. Engl. J. Med.,
October 30, 2003;
349(18):
1738 - 1749.
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. A. Nolan, P. Czobor, B. B. Roy, M. M. Platt, C. B. Shope, L. L. Citrome, and J. Volavka
Characteristics of Assaultive Behavior Among Psychiatric Inpatients
Psychiatr Serv,
July 1, 2003;
54(7):
1012 - 1016.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. de HAAN and T. van AMELSVOORT
Comparable Dopamine 2 Receptor Occupancy
Am J Psychiatry,
December 1, 2002;
159(12):
2118 - 2118.
[Full Text]
|
|
|
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