Change in Cognitive Function after Antipsychotics Treatment : A Pilot Study of Long-Acting Injectable versus Oral Form

Kiyoung Sung; Seoyoung Kim; Euitae Kim

doi:10.16946/kjsr.2018.21.2.74

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Sung, Kim, and Kim: Change in Cognitive Function after Antipsychotics Treatment : A Pilot Study of Long-Acting Injectable versus Oral Form

Original Article

Korean Journal of Schizophrenia Research 2018; 21(2): 74-80.

Published online: 25 October 2018

DOI: https://doi.org/10.16946/kjsr.2018.21.2.74

Change in Cognitive Function after Antipsychotics Treatment : A Pilot Study of Long-Acting Injectable versus Oral Form

Kiyoung Sung, MD¹, Seoyoung Kim, MD², Euitae Kim, MD, PhD^2,³

¹Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea.

²Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.

³Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea.

Address for correspondence: Euitae Kim, Department of Neuropsychiatry, Seoul National University Bundang Hospital, Department of Psychiatry, Seoul National University College of Medicine, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam 13620, Korea. Tel: 031-787-7435, Fax: 031-787-4058, euitae.kim@snu.ac.kr

Received 3 August 2018 Revised 3 September 2018 Accepted 16 September 2018

Korean Society for Schizophrenia Research

Abstract

Objectives

This study investigated whether long-acting injectable (LAI) paliperidone is different from its oral form in terms of the effect on cognitive function in schizophrenia spectrum and other psychotic disorders.

Methods

We reviewed the medical records of patients in Seoul National University Bundang Hospital who were diagnosed as having schizophrenia and/or other psychotic disorders based on DSM-5 from 2016 to 2017. Seven patients were treated with oral paliperidone and 11 were treated with paliperidone palmitate. All patients underwent clinical and neuropsychological assessment, including the Korean version of the MATRICS Consensus Cognitive Battery (MCCB) at their first visit or within one month of their initial treatment. MCCB was repeated within three to 12 months after the initial assessment.

Results

There was no significant difference between the two groups in most cognitive domains including speed of processing, attention and vigilance, working memory, verbal learning, visual learning and reasoning and problem solving domain. However, patients treated with paliperidone palmitate showed better improvement in social cognition domain than those taking oral paliperidone. The standardized values of social cognition domain scores had significantly improved over time in patients under paliperidone palmitate, demonstrating a significant time-by-group interaction.

Conclusion

Our results show that long-acting injectable paliperidone could be helpful in some aspects of improving cognitive function in schizophrenia spectrum and other psychotic disorders. Further studies with other antipsychotics are necessary to generalize the results.

Keywords: Schizophrenia, Long-acting injectables, Cognitive function, Paliperidone

Figures and Tables

Fig. 1

Cognitive change with paliperidone versus paliperidone palmitate. (A) Composite score of MCCB before and after the treatment with paliperidone or paliperidone palmitate. (B) Social cognition of MCCB before and after the treatment with paliperidone or paliperidone palmitate.

Table 1

Demographic and clinical characteristics of the paliperidone treatment group and the paliperidone palmitate treatment group at baseline

Data presented as mean±SD or N (%). * : p<0.05, †: by K-WAIS-IV, ‡: Olanzapine equivalent dose. DUP : Duration of Untreated Psychosis, PANSS : Positive and Negative Syndrome Scale, IQ : Intelligent Quotient, HDRS : Hamilton Depression Rating Scale, CGI-S : Clinical Global Impression-Severity

Table 2

Result of MCCB at baseline

Data presented as median (IQR). * : p<0.05. MCCB : MATRICS Consensus Cognitive Battery, IQR : Interquartile Range

Table 3

Comparison of MCCB T score with paliperidone versus paliperidone palmitate

Data presented as means±SD. * : p<0.05 by repeated measures ANOVA. TMT : Trail Making Test, BACS-SC : Brief Assessment of Cognition in Schizophrenia : Symbol Coding, CF-AN : Category Fluency-Animal Naming, CPT-IP : Continuous Performance Test-Identical Pairs, WMS-III-SS : Wechseler Memory Scale-III-Spatial Span, LNS : Letter-Number Span, HVLT-RTM : Hopkins Verbal Learning Test-Revised TM, BVMTR : Brief Visuospatial Memory Test Revised, NAB-Mazes : Neuropsychological Assessment Battery-Mazes, MSCEIT-ME : Mayer-Salovey-Coruso Emotional Intelligence Test-Managing Emotion

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