Treatments for cognitive symptoms

What are cognitive symptoms?

Cognitive symptoms of schizophrenia have been found in all cognitive domains, including executive function, memory, and attention, and often develop prior to the other symptoms of schizophrenia. They are highly disabling and predict poor functional outcomes.

What is the evidence for treatments for cognitive symptoms?

Moderate to high quality evidence suggests second generation antipsychotics in general are associated with small improvements in processing speed, verbal fluency, learning, motor skills, and global cognition when compared to first generation antipsychotics, but have no benefit over first generation antipsychotics for improving attention, cognitive flexibility, working memory, delayed recall, visuospatial processing. Moderate quality evidence suggests small benefits of second-generation antipsychotics over first-generation antipsychotics for improving long-term memory. There are small benefits of first-generation antipsychotics for improving general cognitive function relative to placebo.

Moderate to high quality evidence shows haloperidol is associated with small improvements in global cognition (low haloperidol dose only), verbal learning (low and high dose), delayed recall (low and high dose), and attention (low dose only), when compared to second generation antipsychotics, with no differences for executive function, verbal fluency, motor skills, or processing speed. Moderate to low quality evidence suggests sertindole may be superior to; clozapine, quetiapine, and first generation antipsychotics for general cognitive ability; clozapine, quetiapine, and olanzapine for memory; clozapine, quetiapine, olanzapine and ziprasidone for executive functioning; and quetiapine for processing speed. Olanzapine may superior to clozapine and first generation antipsychotics for visuospatial skills and verbal fluency. Moderate to high quality evidence suggests small benefits of antidepressants over placebo for global cognition and executive functioning.

March 2019

Last updated at: 3:36 am, 1st April 2019
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