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J Psychiatry Neurosci. 2001 March; 26(2): 137–149.
PMCID: PMC1407745

Neuropsychological change in patients with schizophrenia after treatment with quetiapine or haloperidol.

Abstract

OBJECTIVE: To assess the efficacy of quetiapine, a recently introduced second generation antipsychotic medication, in reducing cognitive impairment in patients with schizophrenia. DESIGN: Prospective, randomized, double-blind clinical trial. PATIENTS: 25 patients who met the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, (DSM-IV) criteria for schizophrenia were recruited from 3 Canadian hospitals. INTERVENTION AND OUTCOME MEASURES: After a 48-hour washout period, 25 patients with schizophrenia were randomly assigned to double-blind treatment with quetiapine or haloperidol for 6 months and evaluated with rating scales for psychotic symptoms, mood and extrapyramidal side effects, as well as standardized neuropsychological measures sensitive to 6 cognitive domains: fine motor skill, attention span, verbal reasoning and fluency, visuospatial construction and fluency, executive skills and visuomotor tracking, and immediate recall of verbal and nonverbal materials. The measures were repeated 8 weeks and 6 months after treatment was initiated. RESULTS: Quetiapine improved psychosis and mood without inducing extrapyramidal symptoms. Quetiapine also had beneficial effects on cognitive skills, particularly verbal reasoning and fluency skills and immediate recall, with additional improvements on executive skills and visuomotor tracking and on the average of the 6 cognitive domains with sustained treatment. Patients taking haloperidol showed improvements in general clinical status, but no specific improvements on the positive syndrome, the negative syndrome, depression ratings or cognitive skills. CONCLUSIONS: These preliminary results support the potential value of quetiapine for improving cognitive impairment in patients with schizophrenia and emphasize the importance of further research with this promising atypical antipsychotic.

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Selected References

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  • Crow TJ. Positive and negative schizophrenic symptoms and the role of dopamine. Br J Psychiatry. 1980 Oct;137:383–386. [PubMed]
  • Spohn HE, Strauss ME. Relation of neuroleptic and anticholinergic medication to cognitive functions in schizophrenia. J Abnorm Psychol. 1989 Nov;98(4):367–380. [PubMed]
  • Kane J, Honigfeld G, Singer J, Meltzer H. Clozapine for the treatment-resistant schizophrenic. A double-blind comparison with chlorpromazine. Arch Gen Psychiatry. 1988 Sep;45(9):789–796. [PubMed]
  • Purdon SE. Measuring neuropsychological change in schizophrenia with novel antipsychotic medications. J Psychiatry Neurosci. 2000 Mar;25(2):108–116. [PMC free article] [PubMed]
  • Keefe RS, Silva SG, Perkins DO, Lieberman JA. The effects of atypical antipsychotic drugs on neurocognitive impairment in schizophrenia: a review and meta-analysis. Schizophr Bull. 1999;25(2):201–222. [PubMed]
  • Goldberg TE, Greenberg RD, Griffin SJ, Gold JM, Kleinman JE, Pickar D, Schulz SC, Weinberger DR. The effect of clozapine on cognition and psychiatric symptoms in patients with schizophrenia. Br J Psychiatry. 1993 Jan;162:43–48. [PubMed]
  • Hagger C, Buckley P, Kenny JT, Friedman L, Ubogy D, Meltzer HY. Improvement in cognitive functions and psychiatric symptoms in treatment-refractory schizophrenic patients receiving clozapine. Biol Psychiatry. 1993 Nov 15;34(10):702–712. [PubMed]
  • Buchanan RW, Holstein C, Breier A. The comparative efficacy and long-term effect of clozapine treatment on neuropsychological test performance. Biol Psychiatry. 1994 Dec 1;36(11):717–725. [PubMed]
  • Chouinard G, Jones B, Remington G, Bloom D, Addington D, MacEwan GW, Labelle A, Beauclair L, Arnott W. A Canadian multicenter placebo-controlled study of fixed doses of risperidone and haloperidol in the treatment of chronic schizophrenic patients. J Clin Psychopharmacol. 1993 Feb;13(1):25–40. [PubMed]
  • Tran PV, Hamilton SH, Kuntz AJ, Potvin JH, Andersen SW, Beasley C, Jr, Tollefson GD. Double-blind comparison of olanzapine versus risperidone in the treatment of schizophrenia and other psychotic disorders. J Clin Psychopharmacol. 1997 Oct;17(5):407–418. [PubMed]
  • Peuskens J, Link CG. A comparison of quetiapine and chlorpromazine in the treatment of schizophrenia. Acta Psychiatr Scand. 1997 Oct;96(4):265–273. [PubMed]
  • Arvanitis LA, Miller BG. Multiple fixed doses of "Seroquel" (quetiapine) in patients with acute exacerbation of schizophrenia: a comparison with haloperidol and placebo. The Seroquel Trial 13 Study Group. Biol Psychiatry. 1997 Aug 15;42(4):233–246. [PubMed]
  • Small JG, Hirsch SR, Arvanitis LA, Miller BG, Link CG. Quetiapine in patients with schizophrenia. A high- and low-dose double-blind comparison with placebo. Seroquel Study Group. Arch Gen Psychiatry. 1997 Jun;54(6):549–557. [PubMed]
  • Purdon SE, Jones BD, Stip E, Labelle A, Addington D, David SR, Breier A, Tollefson GD. Neuropsychological change in early phase schizophrenia during 12 months of treatment with olanzapine, risperidone, or haloperidol. The Canadian Collaborative Group for research in schizophrenia. Arch Gen Psychiatry. 2000 Mar;57(3):249–258. [PubMed]
  • Tollefson GD. Cognitive function in schizophrenic patients. J Clin Psychiatry. 1996;57 (Suppl 11):31–39. [PubMed]
  • Robertson GS, Matsumura H, Fibiger HC. Induction patterns of Fos-like immunoreactivity in the forebrain as predictors of atypical antipsychotic activity. J Pharmacol Exp Ther. 1994 Nov;271(2):1058–1066. [PubMed]
  • Robertson GS, Fibiger HC. Effects of olanzapine on regional C-Fos expression in rat forebrain. Neuropsychopharmacology. 1996 Feb;14(2):105–110. [PubMed]
  • Vahid-Ansari F, Nakabeppu Y, Robertson GS. Contrasting effects of chronic clozapine, Seroquel(TM) (ICI 204,636) and haloperidol administration of deltaFosB-like immunoreactivity in the rodent forebrain. Eur J Neurosci. 1996 May;8(5):927–936. [PubMed]
  • Stip E, Lussier I, Babai M, Fabian JL, Link C. Seroquel and cognitive improvement in patients with schizophrenia. Biol Psychiatry. 1996 Sep 1;40(5):434–435. [PubMed]
  • Sax KW, Strakowski SM, Keck PE., Jr Attentional improvement following quetiapine fumarate treatment in schizophrenia. Schizophr Res. 1998 Oct 9;33(3):151–155. [PubMed]
  • Purdon SE, Labelle A, Boulay L. Neuropsychological change in schizophrenia after 6 weeks of clozapine. Schizophr Res. 2001 Mar 1;48(1):57–67. [PubMed]
  • Addington D, Addington J, Maticka-Tyndale E. Specificity of the Calgary Depression Scale for schizophrenics. Schizophr Res. 1994 Feb;11(3):239–244. [PubMed]
  • Ruff RM, Parker SB. Gender- and age-specific changes in motor speed and eye-hand coordination in adults: normative values for the Finger Tapping and Grooved Pegboard Tests. Percept Mot Skills. 1993 Jun;76(3 Pt 2):1219–1230. [PubMed]
  • Jones-Gotman M, Milner B. Design fluency: the invention of nonsense drawings after focal cortical lesions. Neuropsychologia. 1977;15(4-5):653–674. [PubMed]
  • Geffen GM, Butterworth P, Geffen LB. Test-retest reliability of a new form of the auditory verbal learning test (AVLT). Arch Clin Neuropsychol. 1994 Jul;9(4):303–316. [PubMed]
  • Frith CD. Schizophrenia, memory, and anticholinergic drugs. J Abnorm Psychol. 1984 Aug;93(3):339–341. [PubMed]
  • Bilder RM. Neurocognitive impairment in schizophrenia and how it affects treatment options. Can J Psychiatry. 1997 Apr;42(3):255–264. [PubMed]
  • Purdon SE, Flor-Henry P. Asymmetrical olfactory acuity and neuroleptic treatment in schizophrenia. Schizophr Res. 2000 Sep 1;44(3):221–232. [PubMed]
  • Gallhofer B, Bauer U, Lis S, Krieger S, Gruppe H. Cognitive dysfunction in schizophrenia: comparison of treatment with atypical antipsychotic agents and conventional neuroleptic drugs. Eur Neuropsychopharmacol. 1996;6 (Suppl 2):S13–S20. [PubMed]
  • Green MF, Marshall BD, Jr, Wirshing WC, Ames D, Marder SR, McGurk S, Kern RS, Mintz J. Does risperidone improve verbal working memory in treatment-resistant schizophrenia? Am J Psychiatry. 1997 Jun;154(6):799–804. [PubMed]
  • Green MF. What are the functional consequences of neurocognitive deficits in schizophrenia? Am J Psychiatry. 1996 Mar;153(3):321–330. [PubMed]

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