The Effectiveness of Quetiapine Versus Conventional Antipsychotics in Improving Cognitive and Functional Outcomes in Standard Treatment Settings
Dawn I. Velligan, Thomas J. Prihoda, Dawen Sui, Janice L. Ritch, Natalie Maples, and Alexander L. Miller
J Clin Psychiatry 2003;64(5):524-531
© Copyright 2015 Physicians Postgraduate Press, Inc.
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Objective: To examine the effectiveness of
quetiapine versus conventional antipsychotics in improving
cognitive and functional outcomes.
Method: Forty stable outpatients with DSM-IV
schizophrenia treated in public outpatient clinics were randomly
assigned to continue taking conventional antipsychotic
medications or switch to quetiapine for 6 months, beginning
September 1998 and ending July 2000. Neurocognitive and
functional measures were obtained at study entry, 3 months, and 6
months by raters blinded to treatment. Group differences were
examined using repeated-measures analyses of covariance for mixed
models.
Results: The mean (SD) dose of conventional
antipsychotics in chlorpromazine equivalents was 348.00 (348.28)
mg/day; the mean (SD) dose of quetiapine was 319.25 (142.55)
mg/day. A cognitive function summary score improved in the
quetiapine group relative to the group treated with conventional
antipsychotics over the 6-month period (F = 5.80, df = 1,28.9; p
< .023). Patients taking quetiapine did better with respect to
both verbal fluency (initiation) and verbal memory. There were
also statistically significant group differences with respect to
quality of life favoring the quetiapine group (F = 4.87, df =
1,29; p < .04). Differences were not found with respect to
adaptive functioning.
Conclusion: Quetiapine improved cognition
relative to conventional agents. After 6 months, groups differed
by more than 1 standard deviation when baseline cognitive
functioning was taken into account. No group differences were
found with respect to improvements in community functioning.
Improvements in adaptive functioning may lag behind improvements
in cognition. Psychosocial programming may be necessary to
translate gains in cognition into improvements in adaptive
functioning.