The effect of antipsychotics on the cognitive performance of individuals with psychotic disorders: Network meta-analyses of randomized controlled trials

Baldez, Daniel Prates; Biazus, Tais Boeira; Rabelo‐da‐Ponte, Francisco Diego; Nogaro, Guilherme Pedro; Martins, Dayane Santos; Kunz, Maurício; Czepielewski, Letícia Sanguinetti

doi:10.1016/j.neubiorev.2021.03.028

Cited by 88 publications

(61 citation statements)

References 87 publications

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“…Despite studies examining first episode and chronic patients, comparing multiple different treatments, results were quite inconsistent ( Davidson et al, 2009 ; Sakurai et al, 2013 ). A recent systematic review and meta-analysis ( Baldez et al, 2021 ) comparing several antipsychotics, confirmed the negative effects of haloperidol and evaluated differential effects of amisulpride, quetiapine, lurasidone, olanzapine, perphenazine, risperidone, and ziprasidone on specific cognitive domains.…”

Section: Treatment Of Cognitionmentioning

confidence: 99%

Cognitive dysfunction in schizophrenia: An expert group paper on the current state of the art

Harvey

Bosia

Cavallaro

et al. 2022

Schizophrenia Research: Cognition

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Section: Treatment Of Cognitionmentioning

confidence: 99%

Cognitive dysfunction in schizophrenia: An expert group paper on the current state of the art

Harvey

Bosia

Cavallaro

et al. 2022

Schizophrenia Research: Cognition

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“…Furthermore, the paired-associate learning task was the most effortful and lengthy of all tasks in the cognitive battery, and it is possible that D 2 antagonism impaired the sustained cognitive effort required for this task more than others. Importantly, given antipsychotics as a group differ greatly in their off-target effects outside of dopamine (D 2 ) antagonism, and may differ in effects on cognition as well (35), this study cannot be generalised to all antipsychotics.…”

Section: Discussionmentioning

confidence: 99%

Antipsychotic Effects on Longitudinal Cognitive Functioning in First-Episode Psychosis: A randomised, triple-blind, placebo-controlled study

Allott

Yuen

Baldwin

et al. 2022

Preprint

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Objective: Cognitive impairment occurs in antipsychotic-naive first-episode psychosis (FEP), but antipsychotics confound interpretation of the longitudinal course of cognition. The primary aim was to disentangle the effects of illness from antipsychotics on cognition over the first 6-months of FEP treatment. Methods: Randomised, triple-blind placebo-controlled trial (Staged Treatment and Acceptability Guidelines in Early Psychosis; STAGES), where cognition was a secondary outcome. Antipsychotic-naive FEP patients were allocated to receive risperidone/paliperidone (N=38) or placebo (N=40) in addition to intensive psychosocial therapy for 6-months. A healthy control group (N=42) was also recruited. A cognitive battery assessing attention, working memory, processing speed, verbal fluency, cognitive control and verbal paired-associate learning and memory was administered at baseline and 6-months. Twelve- and 24-month follow-up was also conducted. Results: Over the 6-month trial period, cognitive performance remained stable (working memory, verbal fluency) or improved (attention, processing speed, cognitive control), with no group-by-time interaction evident. The exception was for verbal paired-associate learning and memory, where a significant group-by-time interaction was observed. The placebo and healthy control groups improved, and the medication group deteriorated on immediate paired-associate recall (p=0.039) and delayed cued recall (p=0.005); effect sizes were medium-to-large. Findings were similar when only trial completers were included in the analysis. Conclusions: Risperidone/paliperidone may cause progression of memory impairment in the early months of FEP. Replication is needed in confirmatory trials. The findings support the need for careful consideration of the risks and benefits of various antipsychotics and the importance of accounting for their cognitive effects in longitudinal research.

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“…Several meta-analyses have reflected that atypical antipsychotics elicited a slight improvement in some cognitive functions, while none of them were found to have a positive profile in all cognitive functions [ 85 , 86 ]. In the most recent study, Baldez et al analyzed 54 randomized double-blinded studies to create a ranking of the effect of antipsychotics on neuropsychological tests [ 87 ]. They found that olanzapine was ranked first in motor performance and visuoconstruction, amisulpride came first in attention and verbal memory, ziprasidone in working memory, sertindole in processing speed and perphenazine in executive functions, while lurasidone occupied the first position in a composite score.…”

Section: Treatment Of Cognitive Deficit In Schizophreniamentioning

confidence: 99%

“…They found that olanzapine was ranked first in motor performance and visuoconstruction, amisulpride came first in attention and verbal memory, ziprasidone in working memory, sertindole in processing speed and perphenazine in executive functions, while lurasidone occupied the first position in a composite score. They also observed that clozapine and typical antipsychotics occupied the last positions [ 87 ].…”

Section: Treatment Of Cognitive Deficit In Schizophreniamentioning

confidence: 99%

Cognitive Deficit in Schizophrenia: From Etiology to Novel Treatments

Martínez

Brea

Rico

et al. 2021

IJMS

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Schizophrenia is a major mental illness characterized by positive and negative symptoms, and by cognitive deficit. Although cognitive impairment is disabling for patients, it has been largely neglected in the treatment of schizophrenia. There are several reasons for this lack of treatments for cognitive deficit, but the complexity of its etiology—in which neuroanatomic, biochemical and genetic factors concur—has contributed to the lack of effective treatments. In the last few years, there have been several attempts to develop novel drugs for the treatment of cognitive impairment in schizophrenia. Despite these efforts, little progress has been made. The latest findings point to the importance of developing personalized treatments for schizophrenia which enhance neuroplasticity, and of combining pharmacological treatments with non-pharmacological measures.

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The effect of antipsychotics on the cognitive performance of individuals with psychotic disorders: Network meta-analyses of randomized controlled trials

Cited by 88 publications

References 87 publications

Cognitive dysfunction in schizophrenia: An expert group paper on the current state of the art

Cognitive dysfunction in schizophrenia: An expert group paper on the current state of the art

Antipsychotic Effects on Longitudinal Cognitive Functioning in First-Episode Psychosis: A randomised, triple-blind, placebo-controlled study

Cognitive Deficit in Schizophrenia: From Etiology to Novel Treatments

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