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Changes in cognitive functioning with risperidone and olanzapine treatment: a large-scale, double-blind, randomized study

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Abstract

Objective

The effects of risperidone and olanzapine on cognitive functioning in patients with schizophrenia were compared in a randomized, double-blind trial.

Method

Three hundred and seventy-seven patients were randomly assigned to receive 2–6 mg/day of risperidone or 5–20 mg/day of olanzapine for 8 weeks. Cognitive function was assessed with a focused cognitive assessment battery; in addition, extrapyramidal symptoms were assessed using the extrapyramidal symptom rating scale (ESRS), and the positive and negative syndrome scale (PANSS) was rated for all patients.

Results

Treatment with these two atypical antipsychotic medications was associated with improved performance on the Wisconsin card sorting test, the trail-making test, the California verbal learning test, the continuous performance test, and some aspects of verbal fluency and spatial working memory. No differences in the effects of the drugs on any of the cognitive tests were noted. Correcting for the effects of anticholinergic treatment did not alter the magnitude of cognitive effects.

Conclusions

Atypical antipsychotic treatment is associated with wide-ranging benefits on cognitive functioning. Previous reports of greater benefits of olanzapine over risperidone in a small-sample pilot study were not substantiated. These results are not due in general to changes in clinical symptoms or movement disorders, suggesting a direct effect of atypical antipsychotic medications on cognitive deficits in schizophrenia.

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Acknowledgements

This research was funded by the Janssen Research Foundation.

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Authors and Affiliations

  1. Department of Psychiatry, Mt. Sinai School of Medicine, Box 1229, New York, NY 10029, USA

    Philip D. Harvey & Susan R. McGurk

  2. University of California, Los Angeles, CA, USA

    Michael F. Green

  3. Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, TN 37212, USA

    Herbert Y. Meltzer

Authors
  1. Philip D. Harvey
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  2. Michael F. Green
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  3. Susan R. McGurk
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  4. Herbert Y. Meltzer
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Correspondence to Philip D. Harvey.

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Harvey, P.D., Green, M.F., McGurk, S.R. et al. Changes in cognitive functioning with risperidone and olanzapine treatment: a large-scale, double-blind, randomized study. Psychopharmacology 169, 404–411 (2003). https://doi.org/10.1007/s00213-002-1342-5

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  • DOI: https://doi.org/10.1007/s00213-002-1342-5

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