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European Psychiatry
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le mercredi 7 décembre 2011
Doi : 10.1016/j.eurpsy.2011.10.003
Received : 19 July 2011 ;  accepted : 12 October 2011
Neurocognitive effectiveness of quetiapine, olanzapine, risperidone, and ziprasidone: A pragmatic, randomized trial
 

E. Johnsen a, ⁎ , H.A. Jørgensen b, R.A. Kroken c, E.-M. Løberg d
a Division of Psychiatry, Haukeland University Hospital, Sandviken, Department of Clinical Medicine, Psychiatry, University of Bergen, Norway Sandviksleitet 1, 5035 Bergen, Norway 
b Department of Clinical Medicine, Psychiatry, University of Bergen, Sandviksleitet 1, 5035 Bergen, Norway 
c Division of Psychiatry, Haukeland University Hospital, Sandviken, Sandviksleitet 1, 5035 Bergen, Norway 
d Division of Psychiatry, Haukeland University Hospital, Sandviken, Norway, University of Bergen, Inst. Biological and Medical Psychology, Sandviksleitet 1, 5035 Bergen, Norway 

Corresponding author.
Abstract
Purpose

Cognitive effects of second generation antipsychotics (SGAs) are indicated in efficacy studies but the generalizability of the results may be limited by rigid designs and selected samples. The aim of this naturalistic, industry-independent study is to investigate whether differential neurocognitive effectiveness can be found among olanzapine, quetiapine, risperidone, and ziprasidone in a clinically relevant sample with psychosis.

Subjects and methods

Adult patients acutely admitted to an emergency ward for psychosis were randomized to risperidone, olanzapine, quetiapine or ziprasidone and followed for up to 2 years. Participants were assessed repeatedly using the Positive and Negative Syndrome Scale and a repeatable neurocognitive test battery.

Results

A total of 226 patients were included and 171 patients underwent neurocognitive assessments. The sample had a global cognitive performance score at baseline about one standard deviation below that of the general population. The ziprasidone group had the fastest increase in global functioning which was significantly superior to that of the olanzapine group for the entire follow-up period. Before 90 days, the quetiapine group had the fastest increase which was statistically superior to the olanzapine group.

Discussion

Ziprasidone and quetiapine demonstrated superiority to olanzapine in increasing global neurocognitive performance in this naturalistic sample.


Keywords : Antipsychotics, Cognitive symptoms, Randomized controlled trial, Psychoses


OutlineMasquer le plan
Introduction
Subjects and methods  (+)
Results  (+)
Discussion
Contributors
Disclosure of interest

 Trial Registration: ClinicalTrials.gov ID; URL: http://www.clinicaltrials.gov/: NCT00932529.



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