Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Prédio Anexo, Porto Alegre, 90035-903, Brazil; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Porto Alegre, 90035-003, Brazil.
Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Prédio Anexo, Porto Alegre, 90035-903, Brazil.
Neurosci Biobehav Rev. 2021 Jul;126:265-275. doi: 10.1016/j.neubiorev.2021.03.028. Epub 2021 Apr 1.
Cognitive deficits are a core aspect of psychotic disorders; however, it is not clear to which extent different pharmacological treatments could distinctly impact these outcomes. Hence, we conducted a systematic review and ten network meta-analyses of randomized controlled trials to compare the effect of antipsychotics on cognitive performance of individuals with psychotic disorders. Fifty-four trials were included in the analyses, enrolling 5866 patients. Compared to other antipsychotics, amisulpride performed better on verbal learning; quetiapine on composite score, attention and verbal learning; lurasidone on composite score; olanzapine on composite score and most cognitive domains; perphenazine on composite score, executive function, working memory, and verbal learning; risperidone on executive function and verbal learning; sertindole on processing speed; and ziprasidone on composite score, working memory, and verbal learning. Oppositely, haloperidol performed poorer on all cognitive domains, occupying the last positions in all rankings; and clozapine performed poorer on composite score, executive function, verbal learning, and visuoconstruction. We hope that these results should be taken into account when assessing and treating individuals with psychosis.
认知缺陷是精神障碍的核心方面；然而，不同的药物治疗在多大程度上能够显著影响这些结果还不清楚。因此，我们进行了系统评价和十项网络荟萃分析，以比较抗精神病药物对精神障碍患者认知表现的影响。分析纳入了 54 项试验，共纳入 5866 名患者。与其他抗精神病药物相比，氨磺必利在词语学习方面表现更好；喹硫平在综合评分、注意力和词语学习方面表现更好；鲁拉西酮在综合评分方面表现更好；奥氮平在综合评分和大多数认知领域方面表现更好；奋乃静在综合评分、执行功能、工作记忆和词语学习方面表现更好；利培酮在执行功能和词语学习方面表现更好；司来吉兰在处理速度方面表现更好；齐拉西酮在综合评分、工作记忆和词语学习方面表现更好。相反，氟哌啶醇在所有认知领域的表现都较差，在所有排名中都处于最后位置；氯氮平在综合评分、执行功能、词语学习和视觉构建方面的表现较差。我们希望这些结果在评估和治疗精神病患者时应予以考虑。
