October 1996, Volume 41, Number 8,
Supplement 2
Memory Impairment in Schizophrenia: Perspectives
from Psychopathology and Pharmacotherapy
Emmanuel Stip MD, MSc, CSPQ
Objective:
To describe the concept of memory impairment in schizophrenia and the clinical
implications of this concept in terms of patient assessment and neuroleptic drug use.
Method:
Narrative literature review.
Results:
Individuals suffering from schizophrenia normally exhibit some degree of memory
impairment. Recent work in psychopathology indicates that the impairment is
comprehensive, involving the sensory, short-term, and long-term memory stores. Memory
impairment appears to be a primary symptom of the disease, and its underlying causes are
likely organic. A number of medications, however (for example, traditional neuroleptics
and drugs that have pronounced anticholinergic activity), may cause or exacerbate
impairment. In particular, anticholinergic agents used to treat extrapyramidal symptoms, a
common complication of neuroleptic drugs, appear to have a deleterious effect on memory.
Conclusions:
Memory impairment is an important consideration in the clinical assessment and
management of patients with schizophrenia. The use of atypical antipsychotics like
risperidone appears to have no impact on memory function; because risperidone is
associated with a low incidence of extrapyramidal side effects, it can obviate the need for
anticholinergic medications--thus offering greater hope of nondebilitative intervention.
The advent of medications that are safer (on cognition) could also lead to generally better
outcomes by facilitating compliance with drug regimens and rehabilitation programs.
(Can J Psychiatry 1996;41[2 Suppl]:27S-34S)
Key Words:
schizophrenia, cognition, atypical neuroleptics, risperidone, clozapine, seroquel, memory
The Effect of Risperidone on Cognition in Patients
with Schizophrenia
Emmanuel Stip, MD, MSc, CSPQ, Isabelle Lussier, PhD
Objective:
To evaluate the effect of risperidone on cognitive functions after both 6 weeks and 6 months
of treatment and to determine whether any improvement on neuropsychological function
relates to improvement in psychopathology.
Method:
Patients' psychiatric and extrapyramidal symptoms were assessed while they were
receiving classical neuroleptic treatment and adjunctive medications. Patients were then
reassessed after changing to a new treatment of risperidone.
Results:
During treatment with risperidone, schizophrenic patients displayed improved
performance mainly on attentional components, specifically, selective attention and
alertness.
Conclusion:
In patients who were given risperidone, there was a positive correlation between
improvement in psychopathology and improvement in cognitive tests of explicit memory
and alertness.
(Can J Psychiatry 1996;41[2 Suppl]:35S-40S)
Key Words:
risperidone, atypical neuroleptics, schizophrenia, cognition, attention, memory, adverse
effects