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Second‐generation antipsychotic effect on cognition in patients with schizophrenia—a meta‐analysis of randomized clinical trials
Author(s) -
Nielsen R. E.,
Levander S.,
Kjaersdam Telléus G.,
Jensen S. O. W.,
Østergaard Christensen T.,
Leucht S.
Publication year - 2015
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/acps.12374
Subject(s) - quetiapine , sertindole , olanzapine , ziprasidone , clozapine , risperidone , medicine , antipsychotic , schizophrenia (object oriented programming) , psychiatry , psychology
Objective To investigate the effect of second‐generation antipsychotics on cognitive function in patients diagnosed with schizophrenia or schizoaffective disorder. Method Multiple‐treatments meta‐analysis model. Results On cognitive composite score, sertindole was superior to clozapine, effect size ( ES ) 0.87; 95% CI : 0.12–1.63, quetiapine, ES 0.75; 95% CI : 0.00–1.49, and first‐generation antipsychotics ( FGA s), ES 0.89; 95% CI : 0.14–1.64. Analyses on each cognitive domain showed clozapine, ES 0.37; 95% CI : 0.00–0.74, olanzapine, ES 0.31; 95% CI : 0.02–0.59, quetiapine, ES 0.34; 95% CI : 0.03–0.64, and FGA s, ES 0.51; 95% CI : 0.18–0.83 performing poorer on verbal working memory than ziprasidone, as well as FGA s performing poorer than risperidone, ES 0.31; 95% CI : 0.04–0.58. On executive function, sertindole performed better than clozapine, ES 0.82; 95% CI : 0.06–1.58, olanzapine, ES 0.81; 95% CI : 0.07–1.55, quetiapine, ES 0.76; 95% CI : 0.02–1.51, ziprasidone, ES 0.90; 95% CI : 0.14–1.67, and FGA s, ES 0.83; 95% CI : 0.08–1.58. On processing speed, FGA s performed poorer than sertindole, ES 0.97; 95% CI : 0.02–1.91, and quetiapine, ES 0.36; 95% CI : 0.01–0.72. On long‐term verbal working memory, clozapine performed poorer than olanzapine, ES 0.41; 95% CI : 0.06–0.76. On verbal fluency, FGA s performed poorer than olanzapine, ES 0.26; 95% CI : 0.01–0.50, and clozapine, ES 0.44; 95% CI : 0.06–0.81. Lastly, FGA s, ES 0.41; 95% CI : 0.04–0.78, and clozapine, ES 0.44; 95% CI : 0.05–0.83, performed poorer on visuospatial skill compared to olanzapine. Conclusion The meta‐analysis was able to detect some trends in the data analyzed, but did not show any drug having a uniform positive cognitive profile.