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European Journal of Clinical Pharmacology

, Volume 70, Issue 2, pp 127–134 | Cite as

Long-term neurocognitive effects of antipsychotics in schizophrenia: a network meta-analysis

  • G. Désaméricq
  • F. Schurhoff
  • A. Meary
  • A. Szöke
  • I. Macquin-Mavier
  • A. C. Bachoud-Lévi
  • P. MaisonEmail author
Review Article

Abstract

Purpose

Most schizophrenic patients have mild to moderate cognitive impairment in the early stages of schizophrenia. The aim was to compare the long-term effects of various antipsychotic drugs on overall cognition and on specific cognitive domains in patients with schizophrenia or related disorders.

Methods

We searched MEDLINE and EMBASE for randomized controlled trials in which oral formulations of second-generation antipsychotic drugs were compared head-to-head or against placebo or against haloperidol. Trials had to be of at least 6 months duration to be included. We used a network meta-analysis to combine direct and indirect comparisons of the cognitive effects between antipsychotics.

Results

Nine studies were eligible. The median trial duration was 52 weeks. Quetiapine, olanzapine and risperidone had better effects on global cognitive score than amisulpride (p < 0.05) and haloperidol (p < 0.05). When memory tasks were considered, ziprasidone had better effect than amisulpride (0.28 [0.02–0.54]) and haloperidol (0.32 [0.09–0.55]). Quetiapine was better than other drugs (p < 0.001) on attention and processing speed tasks, followed by ziprasidone (p < 0.05) and olanzapine (p < 0.05). The effects of quetiapine, risperidone and olanzapine were better than those of amisulpride (p < 0.05) on executive functions.

Conclusions

Our results suggest differences between antipsychotics in their effect on the overall cognitive score in schizophrenia. Quetiapine and olanzapine had the most positive effects, followed by risperidone, ziprasidone, amisulpride and haloperidol in that order. Significant differences were also observed according to specific cognitive tasks.

Keywords

Schizophrenia Antipsychotic Neuropsychology Meta-analysis Cognition 

Notes

Acknowledgements

We thank Dr Manuel J. Cuesta, who kindly provided the data necessary for our analysis, and Ingrid Jamin and Eva Bulzacka, who helped to group the neurocognitive tests into cognitive domains.

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

228_2013_1600_MOESM1_ESM.doc (33 kb)
ESM 1 (DOC 33 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • G. Désaméricq
    • 1
    • 2
    • 3
    • 4
  • F. Schurhoff
    • 2
    • 5
    • 6
  • A. Meary
    • 2
    • 5
    • 6
  • A. Szöke
    • 2
    • 5
    • 6
  • I. Macquin-Mavier
    • 2
    • 3
  • A. C. Bachoud-Lévi
    • 1
    • 2
    • 4
    • 7
  • P. Maison
    • 1
    • 2
    • 4
    • 7
    • 8
    Email author
  1. 1.Inserm, U955CréteilFrance
  2. 2.Université Paris Est, Faculté de MédecineCréteilFrance
  3. 3.AP-HP, Hôpital H. Mondor - A. Chenevier, Pharmacologie CliniqueCréteilFrance
  4. 4.Ecole Normale SupérieureDépartement d’Etudes CognitivesParisFrance
  5. 5.Inserm, U955CréteilFrance
  6. 6.AP-HP, Hôpital H. Mondor - A. Chenevier, Pôle de PsychiatrieCréteilFrance
  7. 7.AP-HP, Hôpital H. Mondor - A. Chenevier, Centre de Référence Maladie de HuntingtonCréteilFrance
  8. 8.IMRB - Inserm U955, Equipe 1, Neuropsychologie Interventionnelle, Faculté de Médecine de CréteilCréteilFrance

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