A Comparative Study Of Cognitive Function In Non-acute-phase Schizophrenia Patients After24-week Treatment With Paliperidone

Objectives: Although the new antipsychotic paliperidone extended-release (paliperidone ER) tablets prove effective in relieving both positive and negative symptoms of schizophrenia as well as improving the patients’ social functioning, its specific mechanism of action is unknown. Studies have shown that cognitive impairment in patients with schizophrenia is the core of this disorder. The degree of cognitive deficits is directly associated with illness severity and has a great impact on the prognosis. This study aimed to investigate whether there are cognitive function changes in the non-acute-phase schizophrenia patients after switching prior antipsychotic to paliperidone ER, to evaluate the improvements of symptom severity and personal and social functioning after treatment with paliperidone ER, and to examine whether the cognitive function has an impact on the symptom severity and personal and social functioning.Methods:Twenty non-acute-phase schizophrenia patients who consented to switch prior antipsychotic medication to paliperidone ER were recruited from the psychiatry outpatient clinic and inpatient unit of the First Affiliated Hospital of Kunming Medical University from January to June of2012, and all received24-week treatment. At the point of pre-treatment baseline and the end of week24, we administrated neuropsychological tests and P300potential test to examine the patients’ cognitive function change, the Positive and Negative Syndrome Scale (PANSS) and the Clinical General Impression-Severity scale (CGI-S) to measure the patients’symptom severity, the Personal and Social Performance scale (PSP) to assess their personal and social functioning, the Simpson-Angus Scale (SAS), the Abnormal Involuntary Movement Scale (AIMS), and the Barnes Akathisia Rating Scale (BARS) to evaluate the severity of extrapyramidal symptoms(EPS).Results:(1). There were significant differences (P<0.05) in multiple indicators of neuropsychological tests administrated before and after treatment, including the score of form1of Hopkins Verbal Leaning Test (HVLT), score of Spatial Span (SSP) test, total and form1score of Brief Visuospatial Memory Test (BVMT), score of maze test, score of category fluency test,2-D test score and color connection test form2score of Continuous Performance Task (CPT), and theamplitudeof P3wave in P300potential test.(2). Significant improvements (P=0.00<0.05) in both symptom severity and personal and social functioning were observed on subjects after24-week paliperidone ER treatment, with decreased total (and factor) scores of PANSS and CGI-S, and increased score of PSP.(3). There were significant correlation between cognitive changes and alterations in bothsymptom severity and personal and social functioning, i.e. symptom severity and personal and social functioning were improved along with amelioration of cognitive impairment.Conclusions:(1). Cognitive function is improved significantly in non-acute-phase schizophrenia patients after24-week treatment with paliperidone ER.(2). Paliperidone ER is effective in relieving schizophrenic symptoms and improving patients’personal and social functioning as well.(3). There are significant correlation between cognitive changes and alterations in bothsymptom severity and personal and social functioning. Schizophrenia patients’cognition, clinical symptoms, and personal and social functioning are all improved after treatment with paliperidone ER.