Cognitive functioning and acute sedative effects of risperidone and quetiapine in patients with stable bipolar I disorder: A randomized, double-blind, crossover study

Philip D Harvey, Howard Hassman, Lian Mao, Georges M. Gharabawi, Ramy A. Mahmoud, Luella M. Engelhart

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Objective: Antipsychotic medications differ in their sedative potential, which can affect cognitive performance. The primary objective of this double-blind study was to compare the effects of treatment initiation with risperidone and quetiapine on cognitive function in subjects with stable bipolar disorder. Method: Subjects had a DSM-IV diagnosis of bipolar I disorder in partial or full remission and a Young Mania Rating Scale score ≤ 8 at screening. Subjects were randomly assigned to 1 of 2 treatment sequences: risperidone-quetiapine or quetiapine-risperidone. Subjects in the risperidone-quetiapine sequence received 2 mg of risperidone with dinner and placebo with breakfast during period 1 and 100 mg of quetiapine with dinner and 100 mg with breakfast during period 2. Subjects in the quetiapine-risperidone sequence received the same treatments in reverse order. The 2 treatment periods were separated by a 6- to 14-day washout period. Cognitive function, including attention, working memory, declarative memory, processing speed, and executive functions, was measured before and after dosing. The Visual Analog Scale for Fatigue was also completed. The primary end-point was a neurocognitive composite score (NCS). The study was conducted from November 2004 through August 2005. Results: Thirty subjects were randomly assigned; 28 took all doses of study medication and completed a baseline and at least 1 postbaseline assessment in each treatment. On the NCS, significantly better overall cognitive function was seen after risperidone than after quetiapine at each time point after dosing. Subjects performed significantly better after risperidone than after quetiapine (p < .05) on 9 of the 18 individual cognitive outcome measures and significantly better after quetiapine than after risperidone on 1 measure. Sleeping or the need for sleep during the test days was reported in significantly more patients after receiving quetiapine than risperidone. Conclusions: The results indicate that initiation of quetiapine treatment was associated with more immediate adverse cognitive effects and increased somnolence than risperidone treatment. Clinical Trials Registration: ClinicalTrials.gov identifier NCT00097032.

Original languageEnglish
Pages (from-to)1186-1194
Number of pages9
JournalJournal of Clinical Psychiatry
Volume68
Issue number8
StatePublished - Aug 1 2007
Externally publishedYes

Fingerprint

Risperidone
Hypnotics and Sedatives
Bipolar Disorder
Double-Blind Method
Cross-Over Studies
Cognition
Breakfast
Therapeutics
Meals
Quetiapine Fumarate
Executive Function
Visual Analog Scale
Short-Term Memory
Diagnostic and Statistical Manual of Mental Disorders
Antipsychotic Agents
Fatigue
Sleep
Placebos
Outcome Assessment (Health Care)
Clinical Trials

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Cognitive functioning and acute sedative effects of risperidone and quetiapine in patients with stable bipolar I disorder : A randomized, double-blind, crossover study. / Harvey, Philip D; Hassman, Howard; Mao, Lian; Gharabawi, Georges M.; Mahmoud, Ramy A.; Engelhart, Luella M.

In: Journal of Clinical Psychiatry, Vol. 68, No. 8, 01.08.2007, p. 1186-1194.

Research output: Contribution to journalArticle

Harvey, Philip D ; Hassman, Howard ; Mao, Lian ; Gharabawi, Georges M. ; Mahmoud, Ramy A. ; Engelhart, Luella M. / Cognitive functioning and acute sedative effects of risperidone and quetiapine in patients with stable bipolar I disorder : A randomized, double-blind, crossover study. In: Journal of Clinical Psychiatry. 2007 ; Vol. 68, No. 8. pp. 1186-1194.
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