title: Impact of risperidone versus haloperidol on activities of daily living in the treatment of refractory schizophrenia.
abstract: Risperidone has been shown to improve verbal working memory, executive functioning, attention, reaction time, and verbal learning, which, in turn, have been associated with improved functional outcomes. We tested whether risperidone was associated with greater improvements than haloperidol in activities of daily living (ADLs) among persons having treatment-refractory schizophrenia. In a double-blind, controlled trial of fixed and flexible doses of haloperidol and risperidone, changes in ADLs were operationally monitored on a behavior therapy unit of a state hospital. While no differential effects were noted between risperidone and haloperidol in ADLS, these self-care skills significantly improved as subjects spent longer times on the behavior therapy unit. Working memory and verbal learning did correlate with improvements in ADLs, independent of drug condition. The contingencies of reinforcement and specific training programs on the behavior therapy unit may have been prepotent for the learning of ADLs, obscuring any differential impact of risperidone. Moreover, ADLs may be governed more by "procedural" learning than by working memory or verbal learning, with the former not differentially influenced by typical verus atypical antipsychotics.
authors.affiliation: University of California Los Angeles Center for Research on Treatment and Rehabilitation of Psychosis and Psychiatric Rehabilitation Program, Los Angeles, CA 90095, USA.
authors.forename: Robert Paul
authors.initials: RP
authors.lastname: Liberman
authors.forename: Daniel
authors.initials: D
authors.lastname: Gutkind
authors.forename: Jim
authors.initials: J
authors.lastname: Mintz
authors.forename: Michael
authors.initials: M
authors.lastname: Green
authors.forename: B D
authors.initials: BD
authors.lastname: Marshall
authors.forename: Mary Jane
authors.initials: MJ
authors.lastname: Robertson
authors.forename: Jeffery
authors.initials: J
authors.lastname: Hayden
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001521:Behavior Therapy / Q000379:methods; D003627:Data Interpretation, Statistical; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006220:Haloperidol / Q000627:therapeutic use*; D006801:Humans; D016014:Linear Models; D008297:Male; D018967:Risperidone / Q000627:therapeutic use*; D012559:Schizophrenia / Q000188:drug therapy*; D012648:Self Care
chemical_list: D014150:Antipsychotic Agents; D006220:Haloperidol; D018967:Risperidone