Neurocognitive effects of clozapine, olanzapine, risperidone, and haloperidol in patients with chronic schizophrenia or schizoaffective disorder

Robert M. Bilder, Robert S. Goldman, Jan Volavka, Pal Czobor, Matthew Hoptman, Brian Sheitman, Jean Pierre Lindenmayer, Leslie Citrome, Joseph Patrick McEvoy, Michal Kunz, Miranda Chakos, Thomas B. Cooper, Terri L. Horowitz, Jeffrey A. Lieberman

Research output: Contribution to journalArticle

467 Citations (Scopus)

Abstract

Objective: Newer antipsychotic drugs have shown promise in ameliorating neurocognitive deficits in patients with schizophrenia, but few studies have compared newer antipsychotic drugs with both clozapine and conventional agents, particularly in patients who have had suboptimal response to prior treatments. Method: The authors examined the effects of clozapine, olanzapine, risperidone, and haloperidol on 16 measures of neurocognitive functioning in a double-blind, 14-week trial involving 101 patients. A global score was computed along with scores in four neurocognitive domains: memory, attention, motor function, and general executive and perceptual organization. Results: Global neurocognitive function improved with olanzapine and risperidone treatment, and these improvements were superior to those seen with haloperidol. Patients treated with olanzapine exhibited improvement in the general and attention domains but not more than that observed with other treatments. Patients treated with risperidone exhibited improvement in memory that was superior to that of both clozapine and haloperidol. Clozapine yielded improvement in motor function but not more than in other groups. Average effect sizes for change were in the small to medium range. More than half of the patients treated with olanzapine and risperidone experienced "clinically significant" improvement (changes in score of at least one-half standard deviation relative to baseline). These findings did not appear to be mediated by changes in symptoms, side effects, or blood levels of medications. Conclusions: Patients with a history of suboptimal response to conventional treatments may show cognitive benefits from newer antipsychotic drugs, and there may be differences between atypical antipsychotic drugs in their patterns of cognitive effects.

Original languageEnglish (US)
Pages (from-to)1018-1028
Number of pages11
JournalAmerican Journal of Psychiatry
Volume159
Issue number6
DOIs
StatePublished - Jun 13 2002
Externally publishedYes

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olanzapine
Risperidone
Clozapine
Haloperidol
Psychotic Disorders
Schizophrenia
Antipsychotic Agents
Executive Function
Therapeutics

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Neurocognitive effects of clozapine, olanzapine, risperidone, and haloperidol in patients with chronic schizophrenia or schizoaffective disorder. / Bilder, Robert M.; Goldman, Robert S.; Volavka, Jan; Czobor, Pal; Hoptman, Matthew; Sheitman, Brian; Lindenmayer, Jean Pierre; Citrome, Leslie; McEvoy, Joseph Patrick; Kunz, Michal; Chakos, Miranda; Cooper, Thomas B.; Horowitz, Terri L.; Lieberman, Jeffrey A.

In: American Journal of Psychiatry, Vol. 159, No. 6, 13.06.2002, p. 1018-1028.

Research output: Contribution to journalArticle

Bilder, RM, Goldman, RS, Volavka, J, Czobor, P, Hoptman, M, Sheitman, B, Lindenmayer, JP, Citrome, L, McEvoy, JP, Kunz, M, Chakos, M, Cooper, TB, Horowitz, TL & Lieberman, JA 2002, 'Neurocognitive effects of clozapine, olanzapine, risperidone, and haloperidol in patients with chronic schizophrenia or schizoaffective disorder', American Journal of Psychiatry, vol. 159, no. 6, pp. 1018-1028. https://doi.org/10.1176/appi.ajp.159.6.1018
Bilder, Robert M. ; Goldman, Robert S. ; Volavka, Jan ; Czobor, Pal ; Hoptman, Matthew ; Sheitman, Brian ; Lindenmayer, Jean Pierre ; Citrome, Leslie ; McEvoy, Joseph Patrick ; Kunz, Michal ; Chakos, Miranda ; Cooper, Thomas B. ; Horowitz, Terri L. ; Lieberman, Jeffrey A. / Neurocognitive effects of clozapine, olanzapine, risperidone, and haloperidol in patients with chronic schizophrenia or schizoaffective disorder. In: American Journal of Psychiatry. 2002 ; Vol. 159, No. 6. pp. 1018-1028.
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abstract = "Objective: Newer antipsychotic drugs have shown promise in ameliorating neurocognitive deficits in patients with schizophrenia, but few studies have compared newer antipsychotic drugs with both clozapine and conventional agents, particularly in patients who have had suboptimal response to prior treatments. Method: The authors examined the effects of clozapine, olanzapine, risperidone, and haloperidol on 16 measures of neurocognitive functioning in a double-blind, 14-week trial involving 101 patients. A global score was computed along with scores in four neurocognitive domains: memory, attention, motor function, and general executive and perceptual organization. Results: Global neurocognitive function improved with olanzapine and risperidone treatment, and these improvements were superior to those seen with haloperidol. Patients treated with olanzapine exhibited improvement in the general and attention domains but not more than that observed with other treatments. Patients treated with risperidone exhibited improvement in memory that was superior to that of both clozapine and haloperidol. Clozapine yielded improvement in motor function but not more than in other groups. Average effect sizes for change were in the small to medium range. More than half of the patients treated with olanzapine and risperidone experienced {"}clinically significant{"} improvement (changes in score of at least one-half standard deviation relative to baseline). These findings did not appear to be mediated by changes in symptoms, side effects, or blood levels of medications. Conclusions: Patients with a history of suboptimal response to conventional treatments may show cognitive benefits from newer antipsychotic drugs, and there may be differences between atypical antipsychotic drugs in their patterns of cognitive effects.",
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T1 - Neurocognitive effects of clozapine, olanzapine, risperidone, and haloperidol in patients with chronic schizophrenia or schizoaffective disorder

AU - Bilder, Robert M.

AU - Goldman, Robert S.

AU - Volavka, Jan

AU - Czobor, Pal

AU - Hoptman, Matthew

AU - Sheitman, Brian

AU - Lindenmayer, Jean Pierre

AU - Citrome, Leslie

AU - McEvoy, Joseph Patrick

AU - Kunz, Michal

AU - Chakos, Miranda

AU - Cooper, Thomas B.

AU - Horowitz, Terri L.

AU - Lieberman, Jeffrey A.

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Y1 - 2002/6/13

N2 - Objective: Newer antipsychotic drugs have shown promise in ameliorating neurocognitive deficits in patients with schizophrenia, but few studies have compared newer antipsychotic drugs with both clozapine and conventional agents, particularly in patients who have had suboptimal response to prior treatments. Method: The authors examined the effects of clozapine, olanzapine, risperidone, and haloperidol on 16 measures of neurocognitive functioning in a double-blind, 14-week trial involving 101 patients. A global score was computed along with scores in four neurocognitive domains: memory, attention, motor function, and general executive and perceptual organization. Results: Global neurocognitive function improved with olanzapine and risperidone treatment, and these improvements were superior to those seen with haloperidol. Patients treated with olanzapine exhibited improvement in the general and attention domains but not more than that observed with other treatments. Patients treated with risperidone exhibited improvement in memory that was superior to that of both clozapine and haloperidol. Clozapine yielded improvement in motor function but not more than in other groups. Average effect sizes for change were in the small to medium range. More than half of the patients treated with olanzapine and risperidone experienced "clinically significant" improvement (changes in score of at least one-half standard deviation relative to baseline). These findings did not appear to be mediated by changes in symptoms, side effects, or blood levels of medications. Conclusions: Patients with a history of suboptimal response to conventional treatments may show cognitive benefits from newer antipsychotic drugs, and there may be differences between atypical antipsychotic drugs in their patterns of cognitive effects.

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