title: Long-term neurocognitive effects of olanzapine or low-dose haloperidol in first-episode psychosis.
abstract: BACKGROUND
  Neurocognitive deficits are severe in first-episode psychosis.
  
  
  METHODS
  Patients (N = 263) with first-episode psychosis (schizophrenia, schizoaffective, or schizophreniform disorders) were randomly assigned to double-blind treatment with olanzapine (mean 11.30 mg/day) or haloperidol (mean 4.87 mg/day) for 104 weeks. A neurocognitive battery was administered at baseline (n = 246) and 12 (n = 167), 24 (n = 126), 52 (n = 89), and 104 (n = 46) weeks during treatment. Weighted principal component and unweighted composite scores were derived from individual tests.
  
  
  RESULTS
  Both treatment groups demonstrated significant improvement on both composite scores. On the basis of the weighted composite score, olanzapine had greater improvement than haloperidol only at 12 (p = .014) and 24 (p = .029) weeks. For the unweighted composite, olanzapine had significantly better improvement compared with haloperidol only at week 12 (p = .044). At week 12 only, olanzapine improved performance on the Digit Symbol and Continuous Performance Test significantly more than haloperidol.
  
  
  CONCLUSIONS
  Both antipsychotic agents appeared to improve neurocognitive functioning among first-episode psychosis patients with schizophrenia. A significantly greater benefit in terms of neurocognitive improvement was found with olanzapine than with haloperidol at weeks 12 and 24.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA. richard.keefe@duke.edu
authors.forename: Richard S E
authors.initials: RS
authors.lastname: Keefe
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Seidman
authors.forename: Bruce K
authors.initials: BK
authors.lastname: Christensen
authors.forename: Robert M
authors.initials: RM
authors.lastname: Hamer
authors.forename: Tonmoy
authors.initials: T
authors.lastname: Sharma
authors.forename: Margriet M
authors.initials: MM
authors.lastname: Sitskoorn
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Rock
authors.forename: Sandra
authors.initials: S
authors.lastname: Woolson
authors.forename: Mauricio
authors.initials: M
authors.lastname: Tohen
authors.forename: Gary D
authors.initials: GD
authors.lastname: Tollefson
authors.forename: Todd M
authors.initials: TM
authors.lastname: Sanger
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Lieberman
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001569:Benzodiazepines / Q000008:administration & dosage / Q000009:adverse effects; D003072:Cognition Disorders / Q000139:chemically induced / Q000175:diagnosis* / Q000517:prevention & control; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006220:Haloperidol / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D000077152:Olanzapine; D025341:Principal Component Analysis; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000523:psychology; D018709:Statistics, Nonparametric
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D006220:Haloperidol; D000077152:Olanzapine