Comparative effectiveness of aripiprazole and olanzapine on neurocognitive profile of patients with schizophrenia

Indian J Psychiatry. 2023 Oct;65(10):1044-1051. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_303_23. Epub 2023 Oct 16.

Abstract

Background: Schizophrenia causes significant neurocognitive impairment. Treatment with antipsychotics leads to improvement in psychopathology and neurocognitive functions.

Aim: To see comparative effectiveness of aripiprazole and olanzapine on neurocognitive profile of patients with schizophrenia.

Materials and methods: This was a comparative, prospective, and interventional study. Patients with schizophrenia as per the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), were assessed on Brief Psychiatric Rating Scale (BPRS), Positive and Negative Syndrome Scale (PANSS), and neuropsychological tests at baseline. Patients were randomly assigned to aripiprazole (10-30 mg per day, orally) and olanzapine (5-20 mg per day, orally) groups on the basis of computer-generated random table number. Patients were reassessed at 10 weeks.

Results: A total of 40 patients completed the study duration of 10 weeks. At baseline, the majority of patients showed significant impairment in one or more domains of neurocognition. Both aripiprazole and olanzapine led to improvement in psychiatric symptoms as well as neurocognitive profile. Aripiprazole treatment leads to significant improvement in mental speed as compared to olanzapine. A highly significant decrease in the value of the Stroop effect indicates improvement (P = 0.000**) with aripiprazole and visual-spatial constructive ability (P < 0.001). The olanzapine group showed highly significant improvement in performance of category fluency (P < 0.01) and verbal fluency (P < 0.01).

Conclusion: The study concludes that aripiprazole and olanzapine have strong potential to improve specific domains of neurocognitive profile.

Keywords: Aripiprazole; neurocognitive functions; olanzapine; schizophrenia.