Cognitive Effects of Reducing First-Generation Antipsychotic Dose Compared to Switching to Ziprasidone in Long-Stay Patients with Schizophrenia
Journal of Clinical Medicine, vol. 13, pp. 2112
Abstract
Background: Cognitive impairment is a core symptom of schizophrenia and is associated with functional outcomes. Improving cognitive function is an important treatment goal. Studies have reported beneficial cognitive effects of the second-generation antipsychotic (SGA) ziprasidone. Reducing the dose of first-generation antipsychotics (FGA) might also improve cognitive function. This study compared the cognitive effects in long-stay patients who were randomized to groups who underwent FGA dose reduction or switched to ziprasidone. Methods: High-dose FGA was reduced to an equivalent of 5 mg of haloperidol in 10 patients (FGA-DR-condition), and 13 patients switched to ziprasidone 80 mg b.i.d. (ZIPRA condition). Five domains of cognitive function were assessed before dose reduction or switching (T0) and after 1 year (T1). This study was approved by the ethics committee of the Open Ankh (CCMO number 338) and registered at the Netherlands Trial Register (code 5864). Results: Non-significant deterioration was seen in all cognitive domains studied in the FGA-DR condition, whereas there was a non-significant improvement in all cognitive domains in the ZIPRA condition. The most robust difference between conditions, in favor of ziprasidone, was in executive function. Conclusions: In patients with severe chronic schizophrenia, ziprasidone had a non-significant and very modest beneficial effect on cognitive function compared with FGA dose reduction. Larger trials are needed to further investigate this effect.
Authors 3
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Affiliation as printed
High Care Clinics and Rivierduinen Academy, Mental Health Services Rivierduinen, P.O. Box 405, 2300 AK Leiden, The Netherlands
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Affiliation as printed
High Care Clinics, MHS Rivierduinen, Leiden, and PsyQ and Brijder Addiction Care, 2034 MA Haarlem, The Netherlands
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Amsterdam University Medical Centers
Affiliation as printed
Department of Psychiatry, Amsterdam University Medical Center, 1105 AZ Amsterdam, The Netherlands
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