TY - JOUR
T1 - Rivastigmine treatment as an add-on to antipsychotics in patients with schizophrenia and cognitive deficits
AU - Chouinard, Sylvie
AU - Stip, Emmanuel
AU - Poulin, Julie
AU - Melun, Jean Pierre
AU - Godbout, Roger
AU - Guillem, François
AU - Cohen, Henri
N1 - Funding Information:
Declaration of interest: This research was supported by an Investigator Initiative Trial proposed to Novartis Canada and by the Université de Montréal Eli Lilly Canada Chair in Schizophrenia Research held by Emmanuel Stip, MD. We would like to thank Pierre Lalonde, MD, Ait Lahcen Bentaleb, MD, PhD, Robert Elie, MD, and Georgina Zahirney, MD for their help in recruitment; the nurses Carole Feltrin and Mylène Marchand for their invaluable support with the patients; and Adham Mancini-Marïe, MD for his valuable comments and advice on this paper.
PY - 2007/3
Y1 - 2007/3
N2 - Objective: Although new atypical antipsychotic agents have been found to improve overall cognitive function in patients with schizophrenia (SZ), some aspects of memory, attention and executive functions still remain impaired. Acetylcholinesterase (AChE) inhibitors, such as rivastigmine, have been shown to improve cognition in other disorders, particularly Alzheimer's disease. Dysfunctions in cholinergic systems, especially in the prefrontal cortex, have been identified in SZ, suggesting that cholinesterase inhibitors may be effective in treating cognitive deficits in this disease. Research design and methods: Using a randomized crossover design, we assessed SZ patients with stable symptoms and poor cognitive functioning. Fifty-eight patients with memory deficits, according to subjective complaints or based on clinicians' observations, were assessed with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS). Only 24 of these subjects met the inclusion criteria. Twenty patients took part in the study (four dropped out). All subjects meeting the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria for SZ were maintained on their current antipsychotic medication (18 atypicals and two typicals) and were randomly assigned to treatment with rivastigmine. Dosage was a function of tolerabllity, beginning at 3 mg/day and progressively increasing to 9 mg/day. Subjects were given the Cambridge Neuropsychological Test Automated Battery (CANTAB) at baseline and 3 and 6 months. Results: The results revealed no significant improvement in any of the cognitive variables investigated following rivastigmine treatment and symptom severity scores remained unchanged over all recorded time periods. Conclusion: Rivastigmine treatment did not appear to enhance cognition in SZ patients with important cognitive impairments. This finding needs to be interpreted with care and requires substantiation with larger sample size studies with patients treated with cognitive enhancer for longer periods.
AB - Objective: Although new atypical antipsychotic agents have been found to improve overall cognitive function in patients with schizophrenia (SZ), some aspects of memory, attention and executive functions still remain impaired. Acetylcholinesterase (AChE) inhibitors, such as rivastigmine, have been shown to improve cognition in other disorders, particularly Alzheimer's disease. Dysfunctions in cholinergic systems, especially in the prefrontal cortex, have been identified in SZ, suggesting that cholinesterase inhibitors may be effective in treating cognitive deficits in this disease. Research design and methods: Using a randomized crossover design, we assessed SZ patients with stable symptoms and poor cognitive functioning. Fifty-eight patients with memory deficits, according to subjective complaints or based on clinicians' observations, were assessed with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS). Only 24 of these subjects met the inclusion criteria. Twenty patients took part in the study (four dropped out). All subjects meeting the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria for SZ were maintained on their current antipsychotic medication (18 atypicals and two typicals) and were randomly assigned to treatment with rivastigmine. Dosage was a function of tolerabllity, beginning at 3 mg/day and progressively increasing to 9 mg/day. Subjects were given the Cambridge Neuropsychological Test Automated Battery (CANTAB) at baseline and 3 and 6 months. Results: The results revealed no significant improvement in any of the cognitive variables investigated following rivastigmine treatment and symptom severity scores remained unchanged over all recorded time periods. Conclusion: Rivastigmine treatment did not appear to enhance cognition in SZ patients with important cognitive impairments. This finding needs to be interpreted with care and requires substantiation with larger sample size studies with patients treated with cognitive enhancer for longer periods.
KW - Acetylcholinesterase inhibitors
KW - Cognition
KW - Rivastigmine
KW - Schizophrenia
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U2 - 10.1185/030079906X167372
DO - 10.1185/030079906X167372
M3 - Article
C2 - 17355738
AN - SCOPUS:33947406279
SN - 0300-7995
VL - 23
SP - 575
EP - 583
JO - Current Medical Research and Opinion
JF - Current Medical Research and Opinion
IS - 3
ER -