A double-blind placebo-controlled case study of the use of donepezil to improve cognition in a schizoaffective disorder patient: functional MRI correlates.
Cognitive impairment in multiple domains is common in patients with schizophrenia and may be a powerful determinant of poor functional ability and quality of life. We report a double-blind, placebo-controlled, cross-over study of donepezil augmentation in a schizoaffective disorder patient stabilized on olanzapine pharmacotherapy. The patient showed significant improvements in several cognitive measures and increased activation of prefrontal cortex and basal ganglia on functional MRI during the donepezil augmentation. In addition, the donepezil augmentation resulted in a reduction of depressive symptoms and in significant improvements in functional abilities and quality of life. Further studies of donepezil augmentation of neuroleptics in schizophrenia are warranted.
Risch
S C
SC
Institute of Psychiatry, Medical University of South Carolina, 67 President Street, Room 502N, PO Box 250861, Charleston, SC 29425, USA. rischc@musc.edu
McGurk
S
S
Horner
M D
MD
Nahas
Z
Z
Owens
S D
SD
Molloy
M
M
Gilliard
C
C
Christie
S
S
Markowitz
J S
JS
DeVane
C L
CL
Mintzer
J
J
George
M S
MS
D000328:Adult; D001479:Basal Ganglia / Q000187:drug effects / Q000473:pathology; D001569:Benzodiazepines; D001921:Brain / Q000187:drug effects / Q000473:pathology; D001931:Brain Mapping; D003072:Cognition Disorders / Q000175:diagnosis / Q000188:drug therapy*; D018592:Cross-Over Studies; D000077265:Donepezil; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D006801:Humans; D007189:Indans / Q000008:administration & dosage*; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D000077152:Olanzapine; D010880:Piperidines / Q000008:administration & dosage*; D010890:Pirenzepine / Q000008:administration & dosage / Q000031:analogs & derivatives; D017397:Prefrontal Cortex / Q000187:drug effects / Q000473:pathology; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy*; D011788:Quality of Life
D007189:Indans; D010880:Piperidines; D001569:Benzodiazepines; D010890:Pirenzepine; D000077265:Donepezil; D000077152:Olanzapine