Comparison of Short-Term Clinical and Neurocognitive Outcome Between Atypical and Typical Antipsychotics in First Episode Schizophrenia

Abstract

Treatment with atypical antipsychotics for patients with schizophrenia has been shown to have a beneficial effect on psychotic symptoms as well as a minimization of the medication side-effect profile. However, its effects for negative symptoms and neurocognitive impairments have not been consistently reported. The purpose of this study was to compare the short-term clinical and neurocognitive outcome between the first episode schizophrenic patients treated with atypical antipsychotic risperidone and those treated with conventional antipsychotic haloperidol in a randomized openlabel trial design. A total of 49 patients (29 patients in the risperidone group and 20 patients in the haloperidol group) were recruited. The Positive and Negative Symptoms Scale and High Royds Evaluation of Negativity Scale were used to assess psychotic symptoms. Neurocognitive function tests on attention, memory, and executive function were administered to patients upon admission and discharge. Medication side-effect and drop-out rate were also assessed. Despite the significant improvement of psychotic symptoms in both groups across the trial periods, risperidone did not demonstrate superiority in reduction of psychotic symptoms as well as medication side-effect profile as compared to haloperidol. However, patients in the risperidone group tended to show improvement in the Modified Wisconsin Card Sorting Test. The results indicate that positive symptomatic outcome is very good for first episode schizophrenia, whether treated with haloperidol or risperidone. Negative symptoms improved significantly but not completely in either group. Even though risperidone was used in a short-term treatment, it tends to improve general cognitive impairments in first episode schizophrenic patients as compared to haloperidol.