The neurocognitive effects of low-dose haloperidol: a two-year comparison with risperidone

Green, Michael F.; Marder, Stephen R.; Glynn, Shirley M.; McGurk, Susan R.; Wirshing, William C.; Wirshing, Donna A.; Liberman, Robert Paul; Mintz, Jim

doi:10.1016/s0006-3223(02)01370-7

Cited by 192 publications

(99 citation statements)

References 13 publications

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“…[14][15][16]57,58 Also, in these studies, different antipsychotics have been tested against each other. 57,58 In contrast, EPO has been able as an add-on treatment, on top of a stable antipsychotic medication regime, to specifically target cognition in a group of chronic schizophrenic patients with clearly defined, persistent cognitive decline.…”

Section: H Ehrenreich Et Almentioning

confidence: 99%

“…10,[13][14][15][16] Unfortunately, no drug up till now has been clearly shown to have lasting beneficial effects on cognition in schizophrenia. [14][15][16][17] The increasing evidence of neurodegenerative mechanisms acting in schizophrenia, particularly that derived from imaging data demonstrating progressive loss of cortical gray matter in this condition, [18][19][20] have led to a virtual renaissance of Kraepelin's dementia praecox considerations, 5 and have stimulated novel concepts of the disease, 7,[21][22][23][24][25] including therapeutic neuroprotection. 26 Based on previous observations by ourselves and others, erythropoietin (EPO) appears to be a promising candidate for neuroprotection in schizophrenia.…”

Section: Introductionmentioning

confidence: 99%

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Improvement of cognitive functions in chronic schizophrenic patients by recombinant human erythropoietin

et al. 2006

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Schizophrenia is increasingly recognized as a neurodevelopmental disease with an additional degenerative component, comprising cognitive decline and loss of cortical gray matter. We hypothesized that a neuroprotective/neurotrophic add-on strategy, recombinant human erythropoietin (rhEPO) in addition to stable antipsychotic medication, may be able to improve cognitive function even in chronic schizophrenic patients. Therefore, we designed a doubleblind, placebo-controlled, randomized, multicenter, proof-of-principle (phase II) study. This study had a total duration of 2 years and an individual duration of 12 weeks with an additional safety visit at 16 weeks. Chronic schizophrenic men (N = 39) with defined cognitive deficit (X1 s.d. below normal in the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)), stable medication and disease state, were treated for 3 months with a weekly short (15 min) intravenous infusion of 40 000 IU rhEPO (N = 20) or placebo (N = 19). Main outcome measure was schizophrenia-relevant cognitive function at week 12. The neuropsychological test set (RBANS subtests delayed memory, language-semantic fluency, attention and Wisconsin Card Sorting Test (WCST-64) -perseverative errors) was applied over 2 days at baseline, 2 weeks, 4 weeks and 12 weeks of study participation. Both placebo and rhEPO patients improved in all evaluated categories. Patients receiving rhEPO showed a significant improvement over placebo patients in schizophrenia-related cognitive performance (RBANS subtests, WCST-64), but no effects on psychopathology or social functioning. Also, a significant decline in serum levels of S100B, a glial damage marker, occurred upon rhEPO. The fact that rhEPO is the first compound to exert a selective and lasting beneficial effect on cognition should encourage new treatment strategies for schizophrenia.

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Section: H Ehrenreich Et Almentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Improvement of cognitive functions in chronic schizophrenic patients by recombinant human erythropoietin

et al. 2006

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“…However, SGAs may allow for improvements to take place (due to practice or due to effects beyond practice), while FGAs may preclude such improvements at traditional dosage levels (eg by impairing cognitive and motor learning in the basal ganglia) or may even impede performance (by slowing motor functioning or by requiring anticholinergic medication to control EPMS) (CWGoCTE, 1998;Kasper and Resinger, 2003;Carpenter and Gold, 2002). Interestingly, low-dose haloperidol (5 mg average daily dose) was found to result in similar cognitive improvements in schizophrenic patients as risperidone (6 mg average daily dose) over 2 years (Green et al, 2002), implying that even FGAs may have neurocognitive benefits at lower than traditional doses.…”

Section: Cognitive Improvement In Schizophrenic Patientsmentioning

confidence: 99%

Cognitive Improvement in Schizophrenic Patients does not Require a Serotonergic Mechanism: Randomized Controlled Trial of Olanzapine vs Amisulpride

Wagner

Quednow

Westheide

et al. 2004

Neuropsychopharmacol

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Combined serotonin-2A (5-HT 2A ) and dopamine-2 (D 2 ) receptor blockade has been proposed as a candidate mechanism by which second-generation antipsychotics (SGAs) improve both cognition and negative symptoms in schizophrenic patients, in contrast to antipsychotics of the first generation. The SGA amisulpride, however, only binds to D 2 /D 3 receptors, which makes it an interesting tool to test this assumption. In a randomized controlled trial, 52 schizophrenic patients were allocated to treatment with either olanzapine (10-20 mg/day) or amisulpride (400-800 mg/day). A comprehensive neuropsychological test battery and clinical ratings were used to assess participants at inclusion and after 4 and 8 weeks. Cognitive improvements of moderate size were observed, with effect sizes similar to those obtained in previous studies on the cognitive effects of SGAs. Importantly, amisulpride was not inferior to olanzapine for any cognitive domain. Combined 5-HT 2A /D 2 receptor blockade is probably not necessary for cognitive improvement by SGAs.

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“…In contrast to typical drugs, neurocognitive improvements have been observed with risperidone treatment in the domain of verbal memory (Bilder et al, 2002;Kern et al, 1999) and attention (Harvey et al, 2000;Stip & Lussier, 1996). However, this is not always the case, as other studies have shown no difference between the effects of typical NLP and risperidone treatments on attention (Liu et al, 2000) and verbal learning and memory (Cuesta et al, 2001;Green et al, 2002;Purdon et al, 2000;Stip & Lussier, 1996). These divergent results may be due to differing methodological approaches.…”

Section: Introductionmentioning

confidence: 98%

“…These divergent results may be due to differing methodological approaches. In the majority of studies, there is no healthy comparison group (Bilder et al, 2002;Cuesta et al, 2001;Green et al, 2002;Harvey et al, 2003;Kern et al, 1999;Liu et al, 2000;Purdon et al, 2000;Stip & Lussier, 1996); other studies are conducted at a specific point in time (or over a rather short period; Bilder et al, 2002;Harvey et al, 2000Harvey et al, , 2003Hong et al, 2002;Kern et al, 1999;Liu et al, 2000); and some considered the effects of a single treatment only (Stip & Lussier, 1996) or did not use a conventional NLP as a comparison group (Harvey et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Long-term effects of risperidoneversushaloperidol on verbal memory, attention, and symptomatology in schizophrenia

Rémillard

Pourcher

Cohen

2007

J Int Neuropsychol Soc

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There is evidence in the literature that cognitive functions in schizophrenia (SC) may be improved by atypical neuroleptics (NLPs) in contrast to typical medication, but there is still controversy regarding this apparent superiority of atypical drugs. In this study, we assessed the differential effects of risperidone and haloperidol on verbal memory, attention, and psychiatric symptoms in SC. The performance of 28 SC participants, randomly assigned to risperidone (2-6 mg0day) or haloperidol (2-40 mg0day), was compared with that of healthy controls. The California Verbal Learning Test (CVLT), the d2 Cancellation Test, and the Positive and Negative Symptoms Scale were administered at baseline and 3, 6, and 12 months. Relative to controls, all SC participants showed markedly impaired verbal memory and processing speed at each assessment period. There was no differential effect between the two NLPs on CVLT and d2 performance. However, risperidone was more effective than haloperidol in reducing psychiatric symptoms. Improvement in symptom severity was not associated with improvement in neurocognitive performance on these specific tests. Neither conventional nor atypical neuroleptic medications improved neurocognitive functioning over a 12-month follow-up, suggesting that psychopathological improvement under risperidone is independent of cognitive function. (JINS, 2008, 14, 110-118.)

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The neurocognitive effects of low-dose haloperidol: a two-year comparison with risperidone

Cited by 192 publications

References 13 publications

Improvement of cognitive functions in chronic schizophrenic patients by recombinant human erythropoietin

Improvement of cognitive functions in chronic schizophrenic patients by recombinant human erythropoietin

Cognitive Improvement in Schizophrenic Patients does not Require a Serotonergic Mechanism: Randomized Controlled Trial of Olanzapine vs Amisulpride

Long-term effects of risperidoneversushaloperidol on verbal memory, attention, and symptomatology in schizophrenia

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