Atypicals Don't Improve Cognition

That's startling news, given that part of the hype around the use of atypical antipsyhcotics in schizophrenia and other ailments has been that the SGAs help patients' cognitive functioning, but it is the contention of a paper in this month's Archives of General Psychiatry that, in fact, cognitive gains are the result of so-called practice effect. Meaning that patients who have their cognition improve are seeing such results because they are accustomed to taking the tests used to measure cognition.

From the paper:

"The cognitive improvements observed in the trial were consistent in magnitude with practice effects observed in healthy controls, suggesting that some of the improvements in cognition in the first-episode schizophrenia group may have been due to practice effects (ie, exposure, familiarity, and/or procedural learning). Our results also indicated that differential medication effects on cognition were small."

From one of the study authors in a press account (second item):

"The study’s lead author, Terry Goldberg, said: 'It is a sobering finding (since) the field has just accepted that these medicines enhance cognition. But it may be that (patients are just) getting better at doing the same test over time.

"'If it's just a practice effect, it is a big problem,' he added."

Indeed.