, Volume 169, Issue 3-4, pp 365-366
Date: 02 Sep 2003

Breaking the log-jam in treatment development for cognition in schizophrenia: NIMH perspective

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While current schizophrenia therapeutics are reasonably effective in alleviating delusions and hallucinations, cross-sectional and longitudinal evidence suggests that cognitive impairments, not "positive symptoms" are the major determinants of short- and long-term functional outcome in this disorder (Fujii and Wylie 2003; Sharma and Antonova 2003). Consequently, despite treatment with the best current pharmacological agents, many patients with schizophrenia experience substantial long-term impairment and disability. Indeed, there is no theoretical reason to believe that drugs that act as antagonists at the dopamine2 receptor will reliably enhance cognition in schizophrenia (Carpenter and Gold 2002). As illustrated by articles in this issue of Psychopharmacology, advances in understanding the neuropharmacology and systems-level neurobiology of cognition have yielded at least half a dozen credible models to inform the development of new therapeutics for the cognitive deficits of schizoph