The treatment of cognitive dysfunction in schizophrenia

Schizophrenia is characterized by cognitive deficits in attention, memory, executive function, motor control, language and general intellectual ability. Improving cognitive function is currently an important focus of the management of schizophrenia since deficits in this area contribute to poor clinical and psychosocial outcomes. Antipsychotics remain the mainstay of pharmacological intervention in schizophrenia. Their effects on cognition are therefore important although this is not the primary therapeutic target of these drugs. Treatment with antipsychotics results in modest-to-moderate improvement in most aspects of cognition, which may be greater with atypical than typical agents. Accumulating evidence on the role of dopaminergic, serotonergic, noradrenergic, glutamatergic and cholinergic systems on cognition and on their dysfunction in schizophrenia have opened the way for evaluating compounds to enhance cognition via their actions on specific systems. Results to date are preliminary and insufficient and cannot support specific treatment recommendations. Cognitive rehabilitation techniques offering remedial treatment of cognitive dysfunction in schizophrenia have also been developed and have been found to be a beneficial adjunct to treatment in stable patients with moderate deficits.