Improvements in pharmacological study to fight cognitive impairment in schizophrenia

The UPV/EHU-University of the Basque Country is proposing improvements with respect to the pharmacological study of cognitive function enhancers in patients with schizophrenia

A study by the UPV/EHU has assessed the effectiveness of various drugs, which are used to delay cognitive deterioration in patients with Alzheimer's, in improving cognitive impairment displayed by patients with schizophrenia. Through an analysis of nine clinical trials carried out worldwide, the researchers have specified a series of methodological improvements in the study of drugs that ensure the functional recovery of these patients.

Schizophrenia is a serious, chronic mental disorder involving a series of symptoms. It is one of the leading causes of disability worldwide. Various symptoms of this disorder, such as delusions and hallucinations, have been shown to be very adequately treated by means of antipsychotics, and its symptomatology can be improved. Yet patients experience many difficulties on a social and functional level, in other words, "they have severe problems in carrying out everyday life activities ranging from personal hygiene or managing their finances to maintaining a stable social network, having a partner or holding down a job. And there is no treatment for this", explained Arantzazu Zabala, a Doctor in Psychology specializing in neuropsychology.

Since the year 2000, explained Zabala, one of the authors of the work, "it has emerged that it is the cognitive impairments that correlate most with functional deficits, and since then, to combat these deficits, the scientific community has been developing a broad range of interventions, including cognitive enhancers. These are drugs which when added to the routine, antipsychotic treatment, could reverse or, to a certain extent, reduce the cognitive impairments displayed by patients".

Methodological improvements in the interests of progress

Nine clinical trials from across the world were analysed in a study conducted by researchers from the UPV/EHU, the University of La Rioja, the BioCruces Health Research Institute and Cibersam (Centre for Biomedical Research into Mental Health). The trials involved patients with schizophrenia and used three acetylcholinesterase inhibitors (deonepezil, galantamine and rivastignine)that are very effective in improving the cognitive impairments of patients with Alzheimer's. As the researcher explained, "right now there is insufficient evidence to be able to recommend acetylcholinesterase inhibitors as a cognitive enhancer for patients with schizophrenia". In fact, numerous limitations in the nine trials studied have emerged in this meta-analysis, and various improvements that need to be applied to studies of this type have been proposed.

Doctor Zabala is nevertheless optimistic: "Much work remains to be done, but it's heading in the right direction." The researcher insists that the trials analyzed "are original pieces of work, are among the first ones, but right now the therapeutic targets have expanded greatly. Our work draws attention to the need for studies that will offer sufficient methodological quality to be able to guarantee the effectiveness of the compounds". In this respect, the research conducted at the UPV/EHU proposes a series of improvements in studies of this type, which the scientific community should bear in mind "so that in addition to demonstrating the effectiveness of a drug on the patient's functionality, aspects such as the safety and tolerance of it are also studied," concluded Zabala.

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