Pharmacotherapy of cognitive deficits in schizophrenia

Abstract

While second-generation antipsychotics treat negative as well as positive symptoms, recovery for persons with schizophrenia remains elusive, in part because there are no FDA-approved medications that treat the cognitive deficits of schizophrenia (CDS). Recent work has identified agents that, when added to antipsychotics, improve cognition in schizophrenia. This work and hypothesized mechanisms of action will be reviewed.

Psychometric validation of the consensus five-factor model of the Positive and Negative Syndrome Scale

“…As an independent dimension of pathology in schizophrenia, cognition currently has no proven pharmacological treatment and has emerged as a top priority in schizophrenia research by researchers and clinicians [28,29]. The current findings in general match with previous results [30][31][32] and highlight the potential importance of this factor.…”

Brain plasticity-based therapeutics

“…In the end, only the brain, through its intrinsic plastic processes, can sustain or repair itself, at the level required to sustain high functionality. Those same good reasons explain that while pharmaceutical treatments can often rescue individuals with major neurologically and/or psychiatrically illness, the distortions manifested in their illnesses including the neurological alterations that are the basis of their disease routinely remain unaddressed (e.g., Opler et al, 2014). …”

A systematic review of factors that influence the efficacy of cognitive remediation therapy in schizophrenia

“…Cognitive deficits manifest across a broad range of domains (Schaefer et al, 2013) and have been associated with poorer functional outcomes in areas such as vocational and educational pursuits, independent living and community and social relations (Bowie et al, 2008; Fett et al, 2011; Green, 1996; Strassnig et al, 2015). In the absence of approved pharmacotherapies (Opler et al, 2014), there has been an acceleration of research investigating the efficacy of cognitive remediation therapy (CRT) in ameliorating cognitive deficits with the aim of improving functional outcomes. Meta-analyses quantifying the efficacy of CRT have reported small-to-moderate effect sizes, but have been unable to account for the heterogeneity detected across multiple cognitive domains (Grynszpan et al, 2011; d = 0.38; McGurk et al, 2007; d = 0.41; Revell et al, 2015; d = 0.13; Wykes et al, 2011; d = 0.45).…”