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Re: Aripiprazole controlling bipolar-II » John Bower

Posted by SalArmy4me on August 22, 2001, at 13:48:51

In reply to Aripiprazole controlling bipolar-II, posted by John Bower on August 22, 2001, at 13:25:52

Harvey, Philip D. Ph.D.. Keefe, Richard S.E. Ph.D.. Studies of Cognitive Change in Patients With Schizophrenia Following Novel Antipsychotic Treatment. American Journal of Psychiatry. 158(2):176-184, February 2001.

"Objective: Novel antipsychotic medications have been reported to have beneficial effects on cognitive functioning in patients with schizophrenia. However, these effects have been assessed in studies with considerable variation in methodology. A large number of investigator-initiated and industry-sponsored clinical trials are currently underway to determine the effect of various novel antipsychotics on cognitive deficits in patients with schizophrenia. The ability to discriminate between high- and low-quality studies will be required to understand the true implications of these studies and their relevance to clinical practice.

Method: This article addresses several aspects of research on cognitive enhancement in schizophrenia, emphasizing how the assessment of cognitive function in clinical trials requires certain standards of study design to lead to interpretable results.

Results: Novel antipsychotic medications appear to have preliminary promise for the enhancement of cognitive functioning. However, the methodology for assessing the treatment of cognitive deficits is still being developed.

Conclusions: Researchers and clinicians alike need to approach publications in this area with a watchful eye toward methodological weaknesses that limit the interpretability of findings.


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The past 10 years have seen the introduction of several new antipsychotic medications (referred to as "novel" or "atypical" antipsychotics). While one of these medications, clozapine, has been in use for years in Europe, it was not introduced in the United States until 1990. Among the advantages of novel antipsychotics over "traditional" or "conventional" antipsychotics are reduced extrapyramidal side effect profiles (1, 2), reduced risk for tardive dyskinesia (3, 4), greater effects on the negative and positive symptoms of schizophrenia (5-7), and possible beneficial effects on cognitive functioning. A total of 24 published reports from 20 different studies that were not completely naturalistic have indicated that clozapine (8-21), risperidone (20-28), ziprasidone (29), aripiprazole (29), olanzapine (21, 30), and quetiapine (31) have beneficial effects on cognitive functioning compared to treatment with traditional antipsychotics. Furthermore, adjunctive treatments such as adrenergic, cholinergic, and glutamatergic agents are under investigation in patients with schizophrenia. These agents have the potential to enhance cognition independently of antipsychotic treatment."


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