The treatment of cognitive impairment in schizophrenia.
Cognitive deficits are major contributors to disability in schizophrenia. Many pharmacologic targets have been identified for cognitive enhancing agents, including receptors involved in dopaminergic, glutamatergic, GABAergic, serotonergic and cholinergic neurotransmission. In addition, new approaches to drug development have been directed towards neuroprotection and the facilitation of neuroplasticity. While several pharmacologic agents and cognitive remediation have shown promise in early trials, no treatment has yet demonstrated efficacy in large replication trials. The experience with different pharmacologic targets is reviewed and methodologic issues are discussed with recommendations for future research.
The Schizophrenia Program, Massachusetts General Hospital and Harvard Medical School, USA. goff@psych.mgh.harvard.edu
Donald C
DC
Goff
Michele
M
Hill
Deanna
D
Barch
D000818:Animals; D014150:Antipsychotic Agents / Q000627:therapeutic use; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D018678:Cholinergic Agents / Q000627:therapeutic use; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003072:Cognition Disorders / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D004298:Dopamine / Q000502:physiology; D015259:Dopamine Agents / Q000627:therapeutic use; D018683:Excitatory Amino Acid Agents / Q000627:therapeutic use; D018682:GABA Agents / Q000627:therapeutic use; D006801:Humans; D018697:Nootropic Agents / Q000627:therapeutic use*; D016194:Receptors, N-Methyl-D-Aspartate / Q000187:drug effects; D012559:Schizophrenia / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D018490:Serotonin Agents / Q000627:therapeutic use
D014150:Antipsychotic Agents; D000697:Central Nervous System Stimulants; D018678:Cholinergic Agents; D002800:Cholinesterase Inhibitors; D015259:Dopamine Agents; D018683:Excitatory Amino Acid Agents; D018682:GABA Agents; D018697:Nootropic Agents; D016194:Receptors, N-Methyl-D-Aspartate; D018490:Serotonin Agents; D004298:Dopamine