A meta-analysis and critical review of the effects of conventional neuroleptic treatment on cognition in schizophrenia: opening a closed book

Mishara, Aaron L.; Goldberg, Terry E.

doi:10.1016/j.biopsych.2004.01.027

Cited by 281 publications

(170 citation statements)

References 82 publications

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“…However, this current association may be spurious and may reflect a Type I error. In terms of cognitive change, only the change in Speed of processing of EF was significantly associated with change in symptom severity in the EOS patients, which is in line previous studies of both EOS [16] and AOS patients [56]. In conclusion, we consider both the specific cognitive deficits and their development in our EOS sample to be essentially unaffected by the psychopathological symptoms.…”

Section: Discussionsupporting

confidence: 91%

“…However, the enhancing influence of antipsychotic medications on cognitive functions may be minor, as the improvement in cognitive function associated with atypical [43;88] and typical antipsychotic treatment is relatively small [56]. Although not conclusive, no statistically significant differences in cognitive deficits have been found between EOS patients treated with antipsychotic medications from those untreated [81;85].…”

Section: Discussionmentioning

confidence: 99%

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Deficient maturation of aspects of attention and executive functions in early onset schizophrenia

Jepsen

Fagerlund

Pagsberg

et al. 2010

Eur Child Adolesc Psychiatry

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Word count of the Abstract: 220Word count of the text body: 5819 including the revised Appendix A 3 AbstractThe few existing long-term, neuropsychological follow-up studies of early-onset schizophrenia (EOS) patients have reported relative stability in some cognitive functions but abnormal developmental trajectories in verbal memory, set shifting, aspects of attention, and speed of information processing throughout late adolescence into early adulthood. The current 5-year followup study compared the development of specific cognitive functions in EOS patients (N=17) from the time of first-episode to chronic phase with that of healthy controls (N=38) and secondarily to patients with other early-onset, non-organic, non-affective psychoses (EOP) (N=11). Speed of processing of executive functions, set shifting, and attention improved significantly in the healthy controls and reflected continuous functional maturation during late adolescence and early adulthood. The developmental progression of attention and set shifting but not speed of processing of executive functions was significantly subnormal in EOS patients. Other specific cognitive functions that had attained functional maturity in the healthy controls around the time of the baseline assessment showed normal development in EOS patients during the follow-up period, indicating stable cognitive deficits. These results suggest post-onset developmental deficits in two out of the three aspects of attention and executive functions that have protracted maturational trajectories and that overlap the age of onset of EOS. No significant difference in the development of any specific cognitive function was found between the EOS and EOP group.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Deficient maturation of aspects of attention and executive functions in early onset schizophrenia

Jepsen

Fagerlund

Pagsberg

et al. 2010

Eur Child Adolesc Psychiatry

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“…The absence of detrimental effects of low doses of haloperidol in control subjects and the demonstration of beneficial cognitive effects in patients by equivalent, low doses of haloperidol (Green et al, 2002;Harvey et al, 2005;Keefe et al, 2006b;Mishara and Goldberg, 2004;Remillard et al, 2005;Rollnik et al, 2002) together suggest that conclusions about the cognitive profile of FGAs require careful consideration of dose and receptor occupancy.…”

Section: Discussionmentioning

confidence: 99%

“…Rather, several studies indicated that members of both classes of antipsychotic drugs produce moderate and largely equivalent improvements in cognitive function, particularly when administered at relatively low doses (Green et al, 2002;Harvey et al, 2005;Keefe et al, 2006b;Mishara and Goldberg, 2004;Remillard et al, 2005;Rollnik et al, 2002). Thus, the goal of our research was to define an animal model capable of detecting the limited beneficial cognitive effects of low-dose treatment of an FGA (haloperidol) and an SGA (clozapine; see 'Methods' for the definition and justification of low doses of either drug; Kapur et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Detection of the Moderately Beneficial Cognitive Effects of Low-Dose Treatment with Haloperidol or Clozapine in an Animal Model of the Attentional Impairments of Schizophrenia

Martı́nez

Sarter

2007

Neuropsychopharmacol

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The absence of effective cognition enhancers for the treatment of patients with schizophrenia limits the validation of animal models and behavioral tests used for drug finding and characterization. However, low doses of haloperidol and clozapine were documented to produce moderately beneficial effects in patients. Therefore, this experiment was designed to determine the attentional effects of such treatments in a repeated-amphetamine (AMPH) animal model. Animals were trained in an operant-sustained attention task and underwent a 40-day pretreatment period with saline or increasing doses (1-10 mg per kg) of AMPH. After regaining baseline performance following 10 days of saline treatment, animals were treated with haloperidol (0.025 mg per kg), clozapine (2.5 mg per kg), or vehicle for 10 days. Furthermore, the effects of AMPH challenges (1.0 mg per kg) were assessed. In AMPH-pretreated animals, the administration of AMPH challenges resulted in the disruption of attentional performance. Treatment with haloperidol and clozapine attenuated the detrimental performance effects of these challenges, with clozapine exhibiting more robust attenuation. Furthermore, clozapine, but not haloperidol, impaired the performance of control animals. In contrast, the performance of AMPH-pretreated animals remained unaffected by clozapine. As this animal model detects the moderately beneficial cognitive effects of haloperidol and clozapine, it may be useful for preclinical research designed to detect and characterize treatments for the cognitive symptoms of schizophrenia.

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“…13) While first generation antipsychotics can address the positive symptoms of schizophrenia, they appear to have modest, if any, effect on cognitive performance. 28,29) There was initial hope based on preclinical data that second generation antipsychotics would be more effective in improving cognitive performance. Subsequent clinical studies, however, have not demonstrated any meaningful difference in their effect on cognition between the first and second generation antipsychotics.…”

Section: Cognitive Deficits Are a Core Aspect Of Schizophreniamentioning

confidence: 99%

Cognitive Remediation for Schizophrenia

Mogami¹

2012

PsycEXTRA Dataset

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A meta-analysis and critical review of the effects of conventional neuroleptic treatment on cognition in schizophrenia: opening a closed book

Cited by 281 publications

References 82 publications

Deficient maturation of aspects of attention and executive functions in early onset schizophrenia

Deficient maturation of aspects of attention and executive functions in early onset schizophrenia

Detection of the Moderately Beneficial Cognitive Effects of Low-Dose Treatment with Haloperidol or Clozapine in an Animal Model of the Attentional Impairments of Schizophrenia

Cognitive Remediation for Schizophrenia

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