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Comparative neuropsychological effects of clozpine, risperidone, and haloperidol in treatment-refractory schizophrenia
Dissertation   Open access

Comparative neuropsychological effects of clozpine, risperidone, and haloperidol in treatment-refractory schizophrenia

Terri Lynn Horowitz
Doctor of Philosophy (Ph.D.), Drexel University
Sep 2000
DOI:
https://doi.org/10.17918/00001467
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Abstract

Antipsychotic drugs Cognition--Effect of drugs on Risperidone Schizophrenia
Neuropsychological dysfunction is particularly prominent in patients with treatment-refractory schizophrenia. Until the introduction of clozapine in the late 1980's, traditional antipsychotic medications were generally ineffective in improving neuropsychological functioning, despite their effectiveness in ameliorating the more florid psychiatric symptoms associated with the disease. However, severe cognitive dysfunction is often the rate-limiting factor in getting patients rehabilitated and reintegrated into society. The first atypical antipsychotics, clozapine and risperidone, have reportedly been successful in improving some neuropsychological functions in treatment-refractory patients, likely due to their distinct effects on dopaminergic and serotonergic neurotransmitter systems. In this multicenter, double-blind study, a group of 79 treatment-refractory patients with schizophrenia were randomly assigned to receive clozapine, risperidone, or haloperidol. They were assessed neuropsychologically before and after 14 weeks of treatment. Results showed no significant improvement in cognition with any medication, but there were significant interaction effects indicating that patients responded in different ways to the drugs provided. In particular, patients given risperidone showed trends towards improvement on measures of list learning, semantic fluency, and visuoconstruction when compared with the performance of patients given clozapine or haloperidol. Similar studies with longer medication trials would be necessary to elucidate our understanding of each drug's cognitive effects. Such knowledge would assist clinicians in making appropriate drug choices for patients with debilitating cognitive deficits.

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