The aim of this study was to evaluate the effects of a new antipsychotic compound on negative symptoms and cognitive deficit in schizophrenia. Psychiatric symptoms and cognition were assessed in 25 patients with schizophrenia, at baseline and after they had taken risperidone for 4 weeks. The Positive and Negative Symptoms Scale (PANSS), the Wisconsin Card Sorting Test (WCST) and two WAIS sub-tests were used to assess the patients. After the study period, both negative and positive symptoms and also measures of cognitive performance improved significantly. The WCST results correlated with negative symptom scores before and after treatment. This suggests that negative symptoms and cognitive deficit have a common underlying substrate which is the target of the risperidone treatment. Our data show that risperidone may have a substantial effect on complex cognitive functions in schizophrenia, and they suggest that certain cognitive deficits are relatively dependent on the negative symptoms of this disorder.

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Thirty patients suffering from dysthymic disorder participated in a 6-week double-blind trial comparing ritanserin 10 mg and placebo. After a single-blind placebo wash-out period of one week, the test medication was administered during 5 weeks on a double-blind basis. Twenty-three patients completed the study. At the end of the trial, ritanserin was significantly superior to placebo in its effect as manifested on the 19-item Hamilton Rating Scale for Depression, the Hamilton Rating Scale for Anxiety and the State Trait Anxiety Inventory X-1 and X-2. At the end of the study, the therapeutic effect was rated marked or moderate in 75% of the ritanserin-treated patients, but only in 18% of the controls. These data are consistent with the hypothesis of serotonin abnormalities in dysthymic disorder and suggest a therapeutic role of 5-HT2 antagonists. Ritanserin treatment was very well tolerated; no serious adverse experiences were reported.

Previous studies suggested a therapeutic action of the selective serotonin 5-HT2-antagonist ritanserin on negative symptoms of schizophrenia and on neuroleptic-induced parkinsonism. In this open trial the effect of risperidone, a combined serotonin-5-HT2-and dopamine-D,-antagonist, was studied on a sample of 31 schizophrenic outpatients with an unsatisfactory response to conventional neuroleptic treatment, predominance of negative symptoms, together with troublesome extrapyramidal side-effects. After 28 days of oral treatment (2-6 mg daily) the patients showed a significant improvement as measured by means of the Brief Psychiatric Rating Scale and the Scale for the Assessment of Negative Symptoms. It is possible that the 5-HT2 receptor antagonist properties of risperidone may improve negative symptoms. In addition, confirming previous studies, extrapyramidal symptoms showed a reduced incidence compared to previous neuroleptic treatment, suggesting a serotonin4opamine interaction in the basal ganglia. No electrocardiographic, cardiovascular or laboratory abnormalities were observed.