Effect of second-generation antipsychotics on cognition: current issues and future challenges.

Effect of second-generation antipsychotics on cognition: current issues and future challenges.
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DOI:
10.1586/ern.09.143
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发表时间:
2010-01
影响因子:
4.3
通讯作者:
Sweeney JA
Sweeney JA
中科院分区:
医学3区
文献类型:
--
作者:
Hill SK;Bishop JR;Palumbo D;Sweeney JA

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广泛性认知障碍是与精神分裂症相关的稳定缺陷,也是与功能障碍相关的关键因素。临床前数据表明,第二代抗精神病药物可能会减少认知障碍;然而,最近的大型临床试验表明,相对于第一代抗精神病药物,只有适度的认知益处。这可能反映了药物在人体中的作用有限,与精神分裂症相关的大脑改变导致的差异性药物作用,或用于评估认知结果的神经心理学测试的敏感性有限。可能需要新的促认知药物来实现强大的认知和功能改善。药物发现可能受益于更多地利用翻译神经认知生物标志物来桥接临床前和临床概念验证研究,以优化检测灵敏度,提高成本效率,并加快药物开发的进展。
Generalized cognitive impairments are stable deficits linked to schizophrenia and key factors associated with functional disability in the disorder. Preclinical data suggest that second-generation antipsychotics could potentially reduce cognitive impairments; however, recent large clinical trials indicate only modest cognitive benefits relative to first-generation antipsychotics. This might reflect a limited drug effect in humans, a differential drug effect due to brain alterations associated with schizophrenia, or limited sensitivity of the neuropsychological tests for evaluating cognitive outcomes. New adjunctive procognitive drugs may be needed to achieve robust cognitive and functional improvement. Drug discovery may benefit from greater utilization of translational neurocognitive biomarkers to bridge preclinical and clinical proof-of-concept studies, to optimize assay sensitivity, enhance cost efficiency, and speed progress in drug development.
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