Effectiveness of rivastigmine on positive, negative, and cognitive symptoms of schizophrenia: a double-blind clinical trial | Zendy

Saeed Shoja Shafti | Zendy; Abbas Azizi Khoei | Zendy

Open Access

Effectiveness of rivastigmine on positive, negative, and cognitive symptoms of schizophrenia: a double-blind clinical trial

Author(s) -

Saeed Shoja Shafti,

Abbas Azizi Khoei

Publication year - 2016

Publication title -

therapeutic advances in psychopharmacology

Language(s) - English

Resource type - Journals

eISSN - 2045-1261

pISSN - 2045-1253

DOI - 10.1177/2045125316656334

Subject(s) - rivastigmine , positive and negative syndrome scale , schizophrenia (object oriented programming) , extrapyramidal symptoms , psychology , repeated measures design , medicine , placebo , psychiatry , antipsychotic , analysis of variance , rating scale , clinical trial , psychosis , donepezil , dementia , developmental psychology , disease , statistics , alternative medicine , mathematics , pathology

Background: Several lines of evidence suggest that the cholinergic system may be disrupted in schizophrenia and so this may contribute to the cognitive impairments of schizophrenic patients. Because such deficits do not respond to neuroleptic treatment, different approaches have been done by acetylcholinesterase inhibitors (AChEIs). The objective of the present assessment was to evaluate the safety and clinical effects of rivastigmine, as an adjunctive drug, on the clinical symptoms of schizophrenia.Methods: A total of 46 patients with a diagnosis of schizophrenia entered into a 12-week, double-blind, clinical trial for random assignment to rivastigmine or placebo, as adjuvant to their current antipsychotic medication. Positive and Negative Symptom Scale (PANSS) and Mini Mental State Examination (MMSE) had been used as the primary outcome measures. Clinical Global Impressions- Improvement (CGI-I) Scale and Extrapyramidal Symptom Rating Scale (ESRS) had been used as the secondary measures. Treatment efficacy was evaluated by a Student’s t test and repeated-measures analysis of variance (ANOVA). Statistical significance was defined as a two-sided p value ⩽ 0.05. Cohen’s standard ( d) and correlation measures of effect size ( r) had been calculated for comparing baseline to endpoint changes.Results: According to the findings, except for significant enhancement of MMSE by rivastigmine ( p < 0.001), no significant improvement in PANSS (negative symptoms), PANSS (positive symptoms), and PANSS (general psychopathology) was evident in the target group. Also, except for significant improvement of CGI-I by rivastigmine in intragroup analysis, no significant effectiveness was evident in between-group analysis or repeated-measures ANOVA. ESRS, also, did not show any significant alteration in either group. Effect size (ES) analysis showed a large improvement in MMSE by rivastigmine.Conclusions: According to the findings, while rivastigmine could not induce significant improvement of positive and negative symptoms of schizophrenia, it caused significant enhancement of cognitive function in this group of patients.

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