Abstract
Cognitive impairment is a core symptom domain of schizophrenia. The effect of antipsychotics, the cornerstone of treatment in schizophrenia, on this domain is not fully clear. There is some evidence suggesting that antipsychotics may partially improve cognitive function, and that this improvement may vary depending on the specific cognitive domain. However, this research is confounded by various factors, such as age, duration/stage of illness, medication adherence, and extrapyramidal side effects that complicate the relationship between antipsychotics and cognitive improvement. Furthermore, antipsychotics—particularly the second generation, or “atypical” antipsychotics—can induce serious metabolic side effects, such as obesity, dyslipidemia and type 2 diabetes, illnesses which themselves have been linked to impairments in cognition. Thus, the inter-relationships between cognition and metabolic side effects are complex, and this review aims to examine them in the context of schizophrenia and antipsychotic treatment. The review also speculates on potential mechanisms underlying cognitive functioning and metabolic risk in schizophrenia. We conclude that the available literature examining the inter-section of antipsychotics, cognition, and metabolic effects in schizophrenia is sparse, but suggests a relationship between metabolic comorbidity and worse cognitive function in patients with schizophrenia. Further research is required to determine if there is a causal connection between the well-recognized metabolic adverse effects of antipsychotics and cognitive deficits over the course of the illness of schizophrenia, as well as, to determine underlying mechanisms. In addition, findings from this review highlight the importance of monitoring metabolic disturbances in parallel with cognition, as well as, the importance of interventions to minimize metabolic abnormalities for both physical and cognitive health.
Highlights
Schizophrenia is a severe psychiatric disorder characterized by a wide range of symptoms
There is still a great deal of uncertainty regarding the relationship between cognition, APs, metabolic syndrome (MetS) and schizophrenia
It is tempting to simplify the scenario and assume that as APs induce metabolic dysfunction, cognition should be impaired. This does not seem to consistently be the case, given that in some cases, though metabolic side effects were observed, this was not associated with impairments in cognition
Summary
Schizophrenia is a severe psychiatric disorder characterized by a wide range of symptoms These include positive symptoms, such as hallucinations and delusions, negative symptoms, such as apathy and amotivation, and impaired cognition [1]. Schizophrenia continues to be associated with severe disability, owing largely to cognitive impairments [2], while metabolic illness contributes to decreased patient lifespan by about 20 years due to cardiovascular disease [8]. These two critical domains of health and functioning might interact, as metabolic dysregulation is associated with impaired cognition in both patients with schizophrenia [9], as well as, the non-psychiatrically ill [10]. The inter-relationships between cognition and metabolic side effects are complex, and this review aims to examine them in the context of schizophrenia and AP treatment
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
