The acute effects of amisulpride (50 mg and 200 mg) and haloperidol (2 mg) on cognitive function in healthy elderly volunteers

Abstract

In this double-blind, placebo controlled, four-way cross-over trial in 16 healthy elderly volunteers, the acute effects of haloperidol 2 mg, amisulpride 50 mg and 200 mg, were assessed on a range of tests of cognitive function. On each study day, cognitive performance was assessed prior to dosing and at 2, 4, 6, 9, 12 and 24 h after dosing with the following tests from the Cognitive Drug Research computerized assessment system: simple reaction time, digit vigilance task, choice reaction time, visual tracking, Critical Flicker Fusion, body sway, numeric working memory, immediate and delayed word recall, word recognition and self-ratings of mood and alertness. Haloperidol showed a general tendency to impair performance, and although this did not reach significance compared to placebo, for two tasks there were significant impairments with haloperidol compared to amisulpride. Amisulpride 50 mg and 200 mg, was not associated with impairment. In fact, there was some suggestion of improvement over placebo on three measures. The timings of assessment were appropriate for the study compounds. Furthermore, in a recent study in which a smaller number of elderly volunteers was tested on the same cognitive assessment system, a clear profile of acute impairments of haloperidol 3 mg, was identified. This indicates that haloperidol 2 mg, is not a sufficient dose to affect cognitive function in the elderly, supporting the general absence of effects with this dose in the young. Thus, the general absence of cognitive impairments with amisulpride at the doses used in this study suggests that this compound does not impair cognitive function in the elderly.

Short-Term Cognitive Improvement in Schizophrenics Treated with Typical and Atypical Neuroleptics

“…However, patients treated with typical or atypical neuroleptics did not differ significantly on clinical or neuropsychological scales. This might also indicate that cognitive impairment as a side effect of neuroleptic therapy [17][18][19][20][21][22][23][24] was not different between atypical and typical antipsychotic drugs in our sample. Of course, it has to be taken into account that the sample size was small.…”

“…Patat et al [23] demonstrated that amisulpride (50 mg once daily for 4 days) is devoid of detrimental effects on EEG, psychomotor and cognitive performance after sleep deprivation. The general absence of cognitive impairments with amisulpride (50 and 200 mg) was shown by Legangneux et al [24], while haloperidol (2 mg) showed a general tendency to impair performance. In summary, typical antipsychotic drugs such as haloperidol seem to impair cognitive and psychomotor function, while atypical drugs such as olanzapine or amisulpride are devoid of such detrimental effects (at least over a short observation period).…”

“…Typical neuroleptics might improve cognition in some schizophrenic patients [8], whereas atypical drugs such as clozapine have been reported to improve executive function, verbal fluency, attention and recall memory [12,13]. In addition, it has to be taken into account that neuroleptic drugs per se may alter neuropsychological functioning [17][18][19][20][21][22][23][24]. While haloperidol as a typical neuroleptic may disturb cognitive abilities, atypical antipsychotic drugs (olanzapine, amisulpride) seem to be more beneficial in healthy subjects.…”

Amisulpride for the treatment of very‐late‐onset schizophrenia‐like psychosis

“…Furthermore, these patients may be more susceptible to drug interactions and metabolic changes (Katona, 2001). It is generally acknowledged that the atypical antipsychotic amisulpride has a satisfactory safety profile (among others good pharmacokinetic and cognitive-sparing profile) (Coulouvrat and Dondey-Nouvel, 1999;Ramaekers et al, 1999;Leucht, 2004), promotes social functioning (Saleem et al, 2002), and therefore seems to be a good candidate for treatment of the elderly patients (Hamon-Vilcot et al, 1998;Legangneux et al, 2000). This drug has been shown to be efficacious in dysthymic (Bellino et al, 1997) and psychotic (Möller et al, 2005) elderly patients and in the treatment of behavioural disturbances of patients with moderate to severe Alzheimer's disease (Mauri et al, 2006).…”

Amisulpride versus Risperidone Treatment for Behavioral and Psychological Symptoms in Patients with Dementia of the Alzheimer Type: A Randomized, Open, Prospective Study

“…In a previous study, the elderly (aged 65-80 years) healthy volunteers performed better with single or repeated doses of amisulpride (50-400 mg/day) than with haloperidol (2-4 mg/day) on a range of psychometric and/or cognitive tests [15] . In addition, SPECT imaging showed a significant increase in cerebral blood flow (p !…”