Hospital Pharmacology (Jan 2019)
The influence of typical and atypical antipsychotics on neurocognitive functions in patients with psychotic disorders
Abstract
Introduction: Although before, the prioritization of positive and negative symptoms of schizophrenia over neurocognitive impairment was of the highest importance, recent scientific achievements suggest that the disrupted neurocognitive functions are the core clinical feature of schizophrenia. Both general and specific cognitive functions are impaired. Earlier studies promoted atypical antipsychotics as the ones with the pro-cognitive effect, but an increasing number of recent studies do not demonstrate their superiority on neurocognitive improvement over typical antipsychotics. Aim: The aim of this study was to compare the effects of atypical antipsychotics and a combination of typical and atypical antipsychotics on cognitive functions in patients with psychotic disorders. Furthermore, the effects on gender and duration of disorder on the cognitive functioning of patients on different types of antipsychotic therapy were evaluated, as well as the effect of anticholinergic biperiden in patients receiving combined antipsychotic therapy. Subjects and Methods: This academic IV phase quasi-experimental clinical study included 50 hospitalized patients at the Clinic for Psychiatry at the Clinical Center of Vojvodina, who were divided into two groups of 25 subjects-one consisted of patients who had been on treatment with atypical antipsychotics for six weeks at least, while the second group included patients who had been on combined therapy with typical and atypical antipsychotics for minimum of six weeks. Within the second group, two subgroups could have been recognized; one with 12 patients who were co-medicated with anticholinergic biperidine, whilst the rest of 13 patients were using only combined antipsychotic therapy. All patients' cognitive functions were tested using the Mini-Mental State Examination (MMSE) and the results have been analyzed and compared using t-test. Results: There were no statistically significant difference in cognitive functioning between patients using atypical or combined antipsychotic therapy (p>0.05). There is no statistically signifi cant effect on gender or duration of disorder on cognitive functioning in the two compared groups (p>0.05). There is a statistically significant negative effect on cognition due to the co-medication with biperiden during combined antipsychotic therapy (p<0.05). Conclusions: Atypical antipsychotics did not show superiority in the improvement of neurocognitive functions over combined therapy with atypical and typical antipsychotics. Further investigations should be carried out in order to determine the exact effect of antipsychotics on cognitive functions.
