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Cited by 161Schizophrenia research and treatmentMental Health and PsychiatryDementia and Cognitive Impairment Research

Treatment of cognitive impairment in early psychosis: a comparison of risperidone and haloperidol in a large, long-term trial

Harvey, Philip D., Rabinowitz, Jonathan, Eerdekens, Marielle, Davidson, Michael·2005·American Journal of Psychiatry
DOI 10.1176/appi.ajp.162.10.1888
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Abstract

OBJECTIVE: Cognitive impairment is a major determinant of functional outcome in schizophrenia. Treatment of cognitive impairment at the time of the first episode may have the potential to change functional outcomes of the illness. This study examined changes associated with treatment with risperidone compared with haloperidol in aspects of cognitive functioning known to be associated with functional outcomes. The study was conducted in a large group of patients experiencing their first episode of schizophrenia. METHOD: Cognitive assessments were conducted in 533 patients experiencing their first episode of schizophrenia or a related psychosis who had been randomly assigned to receive low doses of risperidone or haloperidol. The cognitive assessments were repeated at several different follow-up intervals; 359 patients were reexamined at the 3-month follow-up. The assessments included examinations of verbal and visuospatial episodic memory, vigilance, executive functioning, processing speed, and verbal fluency. Patients' clinical symptoms were also rated with the Positive and Negative Syndrome Scale. RESULTS: Improvements from baseline were found in the risperidone-treated patients for episodic memory, verbal fluency, vigilance, executive functioning, and visuomotor speed. Haloperidol-treated patients also showed improvements from baseline in episodic memory, vigilance, and visuomotor speed but not in executive functioning or verbal fluency. Comparison of differential treatment effects on a composite measure of cognitive functioning found that risperidone was significantly more beneficial than haloperidol after 3 months of treatment. Changes in Positive and Negative Syndrome Scale scores were correlated overall with improvement in the haloperidol-treated patients but not in the risperidone-treated patients. CONCLUSIONS: Treatment with risperidone at the time of the first episode of schizophrenia is associated with wide-ranging improvements in cognitive functioning. Overall improvement is significantly greater with risperidone than with haloperidol. Further, cognitive improvement associated with treatment with risperidone was not influenced by changes in symptoms, but that relationship was significant in haloperidol-treated patients.

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Crossref · 10.1176/appi.ajp.162.10.1888

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  • A majority of completed and ongoing trials follow the MATRICS guidelines for studying an adjunctive/cotreatment agent in a randomized, placebo-controlled trial consisting of clinically stable participants with schizophrenia.

    “In general, a majority of completed and ongoing trials follow the MATRICS guidelines17 for studying an adjunctive/cotreatment agent in a randomized, placebo-controlled trial consisting of clinically stable participants with schizophrenia.17,51–53”

    From Clinical trials of potential cognitive-enhancing drugs in schizophrenia: what have we learned so far? (2013) · cites this paper as [52]

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Authors
Harvey, P. D., Rabinowitz, J., Eerdekens, M., & Davidson, M.
Affiliations
Bar-Ilan University (IL)
ORCID
Venue
American Journal of Psychiatry
Publisher
American Psychiatric Association Publishing
Published
2005-10-01
Volume
162
Issue
10
Pages
1888-1895
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
DOI
10.1176/appi.ajp.162.10.1888
OpenAlex
W2166514927
Cited by
161
References
38
Citations by year
2026: 2 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 6 · 2020: 3 · 2019: 3 · 2018: 3 · 2017: 5 · 2016: 7 · 2015: 8 · 2014: 4 · 2013: 7 · 2012: 10
FWCI
10.07
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Keywords
cognitive impairment, first-episode psychosis, schizophrenia, risperidone, haloperidol, antipsychotic drugs, episodic memory, executive function, processing speed, verbal fluency, sustained attention, functional outcome
MeSH terms
Adult, Cognition Disorders, Double-Blind Method, Drug Administration Schedule, Female, Follow-Up Studies, Haloperidol, Humans, Male, Neuropsychological Tests, Psychiatric Status Rating Scales, Psychotic Disorders, Schizophrenia, Schizophrenic Psychology, Time Factors, Antipsychotic Agents, Treatment Outcome, Age of Onset, Risperidone

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