scholarly journals Cognitive effectiveness of olanzapine and risperidone in first-episode psychosis

2009 ◽  
Vol 194 (5) ◽  
pp. 439-445 ◽  
Author(s):  
Manuel J. Cuesta ◽  
Elena García de Jalón ◽  
M. Soledad Campos ◽  
Victor Peralta
Keyword(s):  
Neuropsychological Tests ◽  
Antipsychotic Drugs ◽  
Second Generation ◽  
Reliable Change Index ◽  
First Episode ◽  
Schizophrenia Spectrum Disorders ◽  
Cognitive Improvement ◽  
Schizophrenia Spectrum ◽  
Second Generation Antipsychotic ◽  
Spectrum Disorders

BackgroundCognitive impairment in schizophrenia-spectrum disorders is highly prevalent and notably influences functional outcomes.AimsTo characterise the cognitive effectiveness of second-generation antipsychotic drugs.MethodOne hundred consecutive and previously unmedicated patients with first-episode schizophrenia-spectrum disorders were admitted. Seventy-seven completed baseline, 1-month and 6-month psychopathological and neuropsychological assessments. Patients were randomised to risperidone or olanzapine treatment. Four final treatment allocation groups were defined since patients continued treatment in their normal setting: risperidone, olanzapine, mixed and no-antipsychotic groups.ResultsThere were no differences in cognitive effectiveness between the four treatment groups. Reliable change index methods demonstrated that nearly a half of patients showed an improvement in Global Cognitive Score at the 6-month assessment. Improvement on the neuropsychological tests ranged from 17 to 54%.A strong predictor of cognitive response was poor performance on baseline neuropsychological tests; response was moderately influenced by a low premorbid scholastic performance and IQ.ConclusionsCognitive improvement related to second-generation antipsychotic drugs appeared within the first 4 weeks of treatment and persisted at 6 months irrespective of treatment group. Greater cognitive dysfunction at baseline and lower premorbid cognitive background predicted cognitive improvement in our sample.

scholarly journals Efficacy and safety of individual second-generation vs. first-generation antipsychotics in first-episode psychosis: a systematic review and meta-analysis

2013 ◽  
Vol 16 (6) ◽  
pp. 1205-1218 ◽  
Author(s):  
Jian-Ping Zhang ◽  
Juan A. Gallego ◽  
Delbert G. Robinson ◽  
Anil K. Malhotra ◽  
John M. Kane ◽  
...  
Keyword(s):  
Treatment Response ◽  
First Generation ◽  
Second Generation ◽  
Meta Analysis ◽  
Metabolic Changes ◽  
Treatment Discontinuation ◽  
First Episode ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders

Abstract Because early treatment choice is critical in first-episode schizophrenia-spectrum disorders (FES), this meta-analysis compared efficacy and tolerability of individual second-generation antipsychotics (SGAs) with first-generation antipsychotics (FGAs) in FES. We conducted systematic literature search (until 12 December 2010) and meta-analysis of acute, randomized trials with ⩾1 FGA vs. SGA comparison; patients in their first episode of psychosis and diagnosed with schizophrenia-spectrum disorders; available data for psychopathology change, treatment response, treatment discontinuation, adverse effects, or cognition. Across 13 trials (n = 2509), olanzapine (seven trials) and amisulpride (one trial) outperformed FGAs (haloperidol: 9/13 trials) in 9/13 and 8/13 efficacy outcomes, respectively, risperidone (eight trials) in 4/13, quetiapine (one trial) in 3/13 and clozapine (two trials) and ziprasidone (one trial) in 1/13, each. Compared to FGAs, extrapyramidal symptom (EPS)-related outcomes were less frequent with olanzapine, risperidone and clozapine, but weight gain was greater with clozapine, olanzapine and risperidone. Pooled SGAs were similar to FGAs regarding total psychopathology change, depression, treatment response and metabolic changes. SGAs significantly outperformed FGAs regarding lower treatment discontinuation, irrespective of cause, negative symptoms, global cognition and less EPS and akathisia, while SGAs increased weight more (p < 0.05–0.01). Results were not affected by FGA dose or publication bias, but industry-sponsored studies favoured SGAs more than federally funded studies. To summarize, in FES, olanzapine, amisulpride and, less so, risperidone and quetiapine showed superior efficacy, greater treatment persistence and less EPS than FGAs. However, weight increase with olanzapine, risperidone and clozapine and metabolic changes with olanzapine were greater. Additional FES studies including broader-based SGAs and FGAs are needed.

scholarly journals S201. HIPPOCAMPAL SUBFIELD VOLUMES AND CHANGE IN BODY MASS OVER 12 MONTHS OF TREATMENT IN FIRST-EPISODE SCHIZOPHRENIA SPECTRUM DISORDERS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S114-S115
Author(s):  
Stéfan Du Plessis ◽  
Hilmar Luckhoff ◽  
Sanja Kilian ◽  
Laila Asmal ◽  
Frederika Scheffler ◽  
...  
Keyword(s):  
Substance Use ◽  
Weight Gain ◽  
Body Mass ◽  
Interactive Effect ◽  
First Episode ◽  
Schizophrenia Spectrum Disorders ◽  
Hippocampal Subfields ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
First Episode Schizophrenia

Abstract Background In this study, we explored the relationship between hippocampal subfield volumes and change in body mass over 12 months of treatment in 90 first-episode schizophrenia spectrum disorder patients (66 males, 24 females; mean age= 24.7±6.8 years). Methods Body mass index was assessed in patients at baseline, and at months 3, 6, 9 and 12. Hippocampal subfields of interest were assessed using a segmentation algorithm included in the FreeSurfer 6.0 software program. Results Linear regression analysis showed a significant interactive effect between sex and anterior hippocampus size as a predictor of change in body mass over 12 months, adjusting for age, substance use, treatment duration, and posterior hippocampal volumes. In an exploratory sub-analysis, partial correlations revealed a significant association between weight gain and smaller CA1, CA3 and subiculum volumes in females, but not males, adjusting for age and substance use, with similar trends evident for the CA4 and presubiculum subfields. Discussion In conclusion, our findings suggest that smaller anterior hippocampal subfields are associated with the development of weight gain over the course of treatment in first-episode schizophrenia spectrum disorders in a sex-specific fashion, and may partly explain the more severe and ongoing increase in body mass evident for female patients.

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