Cognitive Dysfunction in Schizophrenia and Its Importance to Outcome: The Place of Atypical Antipsychotics in Treatment

The neurocognitive impairment associated with schizophrenia has been well established. Such impairment may be present prior to the onset of the positive symptoms of schizophrenia and persist during periods of remission. Neurocognitive deficits predict multiple domains of outcome; treating such deficits is therefore regarded as highly important. Conventional antipsychotic agents do not appear to favorably affect cognitive function in schizophrenia. Indeed, their propensity to induce adverse effects such as extrapyramidal symptoms may further impair cognitive function. A growing body of evidence suggests that patients taking atypical antipsychotics perform better on some tests of neurocognitive ability than patients receiving conventional agents, with implications for adaptive functioning. The neurocognitive benefits of the atypical antipsychotic agents discussed in this article support their use as a first-line therapy for schizophrenia.