Beneficial effect of new atypical antipsychotics on cognition is not returning most schizophrenic patients to normative standards of cognitive functioning. Therefore, other treatments need to be considered as augmentation therapy. Subtle changes in cholinergic function may contribute to the cognitive impairment associated with schizophrenia. Donepezil-cholinesterase inhibitor may act as augmenting agent that manages cholinergic dysfunction in patients with schizophrenia.
The aim of study: assessing results of 4, and 8-weeks treatment with donepezil (S-10 mg/day) and new atypical antipsychotics in schizophrenic patients.
Material: 30 subjects with schizophrenia (ICD-10) in stabilization phase, (in period or improvement of mental state during at least last 6 months, and with score in chosen items of positive symptoms subscale of PANSS: delusions, hallucinations, excitement, grandiosity, and suspicious/persecutory less than 4 points), aged 18-42, treated with risperidone or olanzapine.
Methods: Donepezil (S-l0 mg daily dose) was added to risperidone or olanzapine treatment. This treatment was continued for 8 weeks. Before start of the trial and after 4 and 8 weeks of pharmacotherapy subject were assessed with PANSS, ESRS and neuropsychological tests: TNT A and B, Stroop’s Test and WCST.
Conclusions: Treatment with new atypical antypsychotics and donepezil was safe and well tolerated. Neither the 5 mg nor 10 mg dose of donepezil produced significant improvements in any cognitive measure compared with baseline data (verbal function – Stoop’s Test, attention, psychomotoric functions, visuospatial working memory – TMT, and other aspects of working memory and executive functions – WCST).