Long-Acting Injectable Plus Cognitive Training Boosts Function in Early Schizophrenia

Treatment with the long-acting injectable antipsychotic risperidone combined with cognitive training significantly improved cognitive deficits in patients after a first episode of schizophrenia, according to a study published online in Psychological Medicine.

“Cognitive deficits at the first episode of schizophrenia are predictive of functional outcome,” wrote lead author Keith Nuechterlein, PhD, of the University of California, Los Angeles, and colleagues. “Interventions that improve cognitive functioning early in schizophrenia are critical if we hope to prevent or limit long-term disability in this disorder.”

The 12-month randomized controlled trial included 60 patients with a recent first episode of schizophrenia. Each was randomized to risperidone in either oral or long-acting injectable form and to either cognitive remediation or healthy behavior training in nutrition, stress management, and exercise. All patients were provided supported employment or education to encourage return to work or school.

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Treatment with the long-acting injectable combined with cognitive remediation, which covered training in attention, memory, and problem-solving skills to help patients navigate complex life situations, resulted in improved cognition and increased productivity, the study found. Patients who received the combination treatment had significant improvements in work and school function.

“These results indicate that consistent antipsychotic medication adherence and cognitive remediation can significantly improve core cognitive deficits in the initial period of schizophrenia,” researchers wrote. “When combined with supported employment/education, cognitive remediation and long-acting injectable antipsychotic medication show separate significant impact on improving work/school functioning.”

—Jolynn Tumolo

References

Nuechterlein KH, Ventura J, Subotnik KL, et al. A randomized controlled trial of cognitive remediation and long-acting injectable risperidone after a first episode of schizophrenia: improving cognition and work/school functioning. Psychological Medicine. 2020 September 28;[Epub ahead of print].

Long-acting antipsychotic therapy plus cognitive training show promise for schizophrenia [press release]. Los Angeles, California: University of California, Los Angeles (UCLA), Health Sciences; November 19, 2020.