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Cognitive improvements with antipsychotics: real or practice effect?

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Terry Goldberg

Correspondence to: Terry Goldberg, PhD, Zucker Hillside Hospital, 7559 263rd Street, Glen Oaks, NY 11004, USA; tgoldberg@nshs.edu

QUESTION

Question:

Do the effects of olanzapine and risperidone on cognition in first-episode schizophrenia differ, and are the effects real or the result of repeating the tests?

Patients:

104 people with DSM-IV first episode schizophrenia (76 with schizophrenia, 10 with schizoaffective disorder, and 18 with schizophreniform disorder) recruited through hospital-based research units who were all actively psychotic on enrolment; 84 healthy controls were recruited through newspaper advertisements and word of mouth. Exclusions: medical condition affecting the central nervous system, and having neurological conditions or taking drugs that affected cognition.

Setting:

Hospitals in the USA; time period not stated.

Intervention:

People with first-episode schizophrenia (FES) were randomised to receive olanzapine (2.5–20 mg/d) or risperidone (1–6 mg/d) for 16 weeks. Healthy controls did not receive any medication.

Outcomes:

Severity of illness (Schedule for Affective Disorders and Schizophrenia-Change Version; Schedule for the Assessment of Negative Symptoms); change in cognition (16 tests assessed domains including mental status, speed, executive function, memory and motor skills) all …

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