The effects of guanfacine on context processing abnormalities in schizotypal personality disorder.
BACKGROUND
The signature of impaired cognition in people with schizotypal personality disorder (SPD) may be centrally related to working memory impairments. Guanfacine, an alpha2A agonist that acts post-synaptically in the prefrontal cortex (PFC), has shown potential for reducing working memory limitations in other populations. This study examined the potential of guanfacine for improving context processing, a feature of working memory, in SPD.


METHODS
29 individuals with SPD entered into a 4-week, randomized parallel-design, double-blind, placebo-controlled trial of guanfacine treatment, followed by a 4-week open-label extension. A modified version of the AX-Continuous Performance Test (AX-CPT) was administered. On this task, evidence of intact context processing includes few BX errors (false cue, correct probe) and higher levels of AY errors (correct cue, false probe).


RESULTS
At the end of double-blind treatment, participants treated with guanfacine demonstrated a significant reduction in BX errors and a small but significant increase in AY errors, a pattern that was not seen in the participants treated with placebo.


CONCLUSIONS
SPD participants improved in their context processing toward a normal response bias, making fewer BX and more AY errors, after being treated with guanfacine.
McClure
Margaret M
MM
VA VISN3 Mental Illness Research, Education, and Clinical Center, Bronx, New York 10468, USA. margaret.mcnamara@mssm.edu
Barch
Deanna M
DM
Romero
Michelle J
MJ
Minzenberg
Michael J
MJ
Triebwasser
Joseph
J
Harvey
Philip D
PD
Siever
Larry J
LJ
D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use*; D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D016316:Guanfacine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008570:Memory, Short-Term / Q000187:drug effects*; D008875:Middle Aged; D009483:Neuropsychological Tests; D011930:Reaction Time / Q000187:drug effects; D012569:Schizotypal Personality Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology
D000316:Adrenergic alpha-Agonists; D016316:Guanfacine