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The neurocognitive effects of aripiprazole: an open-label comparison with olanzapine

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Abstract

Rationale

Cognitive deficits are a core feature of schizophrenia. As a target of intervention, improvements in cognition may lead to improvements in functional outcome.

Objectives

The present paper is the first report, to our knowledge, on the neurocognitive effects of aripiprazole. Unlike other second-generation antipsychotics, aripiprazole is a D2 and D3 receptor partial agonist. It is unknown what effects this unusual pharmacological profile may yield on neurocognition.

Materials and methods

The present open-label study included data on 169 patients with schizophrenia or schizoaffective disorder who were randomly treated with aripiprazole or olanzapine. Subjects received a neurocognitive battery at baseline, week 8, and 26.

Results

The aripiprazole group had a significantly greater dropout rate than the olanzapine group. Neurocognitive data were reduced through a principal components analysis that yielded a three-factor solution. The factors were general cognitive functioning, executive functioning, and verbal learning. For general cognitive functioning, both groups improved from baseline and the effects were relatively stable over the 26-week protocol. There were no differential treatment effects. For executive functioning, neither group improved significantly from baseline. For verbal learning, the aripiprazole group improved significantly from baseline to the 8th and 26th week of assessment, and there was a between-group effect favoring aripiprazole over olanzapine that was largely attributable to the differences in performance within the 8th week. Separate analyses were conducted for a measure of sustained attention (Continuous Performance Test–Identical Pairs). There were no differential treatment effects on this measure.

Conclusions

The findings from this open-label study suggest that the neurocognitive effects of aripiprazole are at least as good as those of olanzapine.

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Acknowledgements

The authors would like to thank the patients and staff of the participating hospitals and clinics who made this study possible. Dr. Kern, Dr. Green, and Dr. Cornblatt have served as consultants for Otsuka America Pharmaceutical and Dr. Green and Dr. Cornblatt have also served as consultants for Bristol-Myers Squibb Company. Dr. Kern, Dr. Green, and Dr. Cornblatt received no funds or other compensation for preparation of this manuscript. The data analyses were conducted by Jim Mintz, Ph.D., UCLA Department of Psychiatry and Biobehavioral Sciences and Department of Veterans Affairs VISN 22 MIRECC. Funding for this research study was provided by Otsuka America Pharmaceutical.

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Authors and Affiliations

  1. Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Robert S. Kern & Michael F. Green

  2. VA Greater Los Angeles Healthcare Center (MIRECC 210A), 11301 Wilshire Boulevard, Los Angeles, CA, 90073, USA

    Robert S. Kern

  3. Department of Veterans Affairs VISN 22, Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA

    Robert S. Kern & Michael F. Green

  4. Albert Einstein College of Medicine, Bronx, NY, USA

    Barbara A. Cornblatt

  5. Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, NY, USA

    Barbara A. Cornblatt

  6. Bristol-Myers Squibb Company, Wallingford, CT, USA

    J. Randall Owen & Ron Marcus

  7. Otsuka America Pharmaceutical, Incorporated, Princeton, NJ, USA

    Robert D. McQuade & William H. Carson

  8. Otsuka Maryland Research Institute, Rockville, MD, USA

    Mirza Ali

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  1. Robert S. Kern
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Correspondence to Robert S. Kern.

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Kern, R.S., Green, M.F., Cornblatt, B.A. et al. The neurocognitive effects of aripiprazole: an open-label comparison with olanzapine. Psychopharmacology 187, 312–320 (2006). https://doi.org/10.1007/s00213-006-0428-x

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  • DOI: https://doi.org/10.1007/s00213-006-0428-x

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