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Erschienen in: Der Nervenarzt 5/2010

01.05.2010 | Übersichten

Behandlung kognitiver Defizite bei Schizophrenie

Teil II: Pharmakologische Strategien

verfasst von: Dr. D. Roesch-Ely, U. Pfueller, C. Mundt, U. Müller, M. Weisbrod

Erschienen in: Der Nervenarzt | Ausgabe 5/2010

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Zusammenfassung

Kognitive Defizite bilden eine klinisch relevante und für den Verlauf entscheidende Symptomgruppe der Schizophrenie. Die pharmakologische Behandlung der kognitiven Defizite stellt eine Herausforderung dar. Ziel dieses Artikels ist es, eine theoretisch fundierte und klinisch bedeutungsvolle Übersicht über die pharmakologischen Strategien der Behandlung kognitiver Defizite bei schizophrenen Psychosen zu geben. Die für die Behandlung schizophrener Psychosen zugelassenen Antipsychotika der 1. Generation sind hinsichtlich ihrer Wirkung auf die Kognition noch kontrovers. Die Antipsychotika der 2. Generation zeigen einen allenfalls geringen positiven Einfluss und sind denen der 1. Generation nicht nachweisbar überlegen. Vielversprechend erscheint der gezielte Einsatz von Präparaten, die kognitive Prozesse spezifisch beeinflussen können, so genannte kognitionsverbessernde Substanzen („cognition-enhancing drugs“).
Literatur
1.
Zurück zum Zitat Allain H, Lieury A, Brunet-Bourgin F et al (1992) Antidepressants and cognition: comparative effects of moclobemide, viloxazine and maprotiline. Psychopharmacology 106 [Suppl]:56–61 Allain H, Lieury A, Brunet-Bourgin F et al (1992) Antidepressants and cognition: comparative effects of moclobemide, viloxazine and maprotiline. Psychopharmacology 106 [Suppl]:56–61
2.
Zurück zum Zitat Apud JA, Mattay V, Chen J et al (2007) Tolcapone improves cognition and cortical information processing in normal human subjects. Neuropsychopharmacology 32:1011–1020CrossRefPubMed Apud JA, Mattay V, Chen J et al (2007) Tolcapone improves cognition and cortical information processing in normal human subjects. Neuropsychopharmacology 32:1011–1020CrossRefPubMed
3.
Zurück zum Zitat Apud JA, Weinberger DR (2007) Treatment of cognitive deficits associated with schizophrenia: potential role of catechol-O-methyltransferase inhibitors. CNS Drugs 21:535–557CrossRefPubMed Apud JA, Weinberger DR (2007) Treatment of cognitive deficits associated with schizophrenia: potential role of catechol-O-methyltransferase inhibitors. CNS Drugs 21:535–557CrossRefPubMed
4.
Zurück zum Zitat Arnsten AF, Cai JX, Murphy BL et al (1994) Dopamine D1 receptor mechanisms in the cognitive performance of young adult and aged monkeys. Psychopharmacology 116:143–151CrossRefPubMed Arnsten AF, Cai JX, Murphy BL et al (1994) Dopamine D1 receptor mechanisms in the cognitive performance of young adult and aged monkeys. Psychopharmacology 116:143–151CrossRefPubMed
5.
Zurück zum Zitat Arnsten AF, Goldman-Rakic PS (1985) Alpha 2-adrenergic mechanisms in prefrontal cortex associated with cognitive decline in aged nonhuman primates. Science 230:1273–1276CrossRefPubMed Arnsten AF, Goldman-Rakic PS (1985) Alpha 2-adrenergic mechanisms in prefrontal cortex associated with cognitive decline in aged nonhuman primates. Science 230:1273–1276CrossRefPubMed
6.
Zurück zum Zitat Arnsten AF, Jentsch JD (1997) The alpha-1 adrenergic agonist, cirazoline, impairs spatial working memory performance in aged monkeys. Pharmacol Biochem Behav 58:55–59CrossRefPubMed Arnsten AF, Jentsch JD (1997) The alpha-1 adrenergic agonist, cirazoline, impairs spatial working memory performance in aged monkeys. Pharmacol Biochem Behav 58:55–59CrossRefPubMed
7.
Zurück zum Zitat Barch DM, Carter CS (2005) Amphetamine improves cognitive function in medicated individuals with schizophrenia and in healthy volunteers. Schizophr Res 77:43–58CrossRefPubMed Barch DM, Carter CS (2005) Amphetamine improves cognitive function in medicated individuals with schizophrenia and in healthy volunteers. Schizophr Res 77:43–58CrossRefPubMed
8.
Zurück zum Zitat Barnett JH, Croudace TJ, Jaycock S et al (2007) Improvement and decline of cognitive function in schizophrenia over one year: a longitudinal investigation using latent growth modelling. BMC Psychiatry 7:16CrossRefPubMed Barnett JH, Croudace TJ, Jaycock S et al (2007) Improvement and decline of cognitive function in schizophrenia over one year: a longitudinal investigation using latent growth modelling. BMC Psychiatry 7:16CrossRefPubMed
9.
Zurück zum Zitat Blyler CR, Gold JM (2000) Cognitive Effects of typical antipsychotic treatment: another look. In: Sharma T, Harvey PD (eds) Cognition in Schizophrenia: Impairments, Importance and Treatment Strategies. Oxford Univ Press, Oxford Blyler CR, Gold JM (2000) Cognitive Effects of typical antipsychotic treatment: another look. In: Sharma T, Harvey PD (eds) Cognition in Schizophrenia: Impairments, Importance and Treatment Strategies. Oxford Univ Press, Oxford
10.
Zurück zum Zitat Bucci L (1987) The negative symptoms of schizophrenia and the monoamine oxidase inhibitors. Psychopharmacology 91:104–108CrossRefPubMed Bucci L (1987) The negative symptoms of schizophrenia and the monoamine oxidase inhibitors. Psychopharmacology 91:104–108CrossRefPubMed
11.
Zurück zum Zitat Buchanan RW, Conley RR, Dickinson D et al (2008) Galantamine for the treatment of cognitive impairments in people with schizophrenia. Am J Psychiatry 165:82–89CrossRefPubMed Buchanan RW, Conley RR, Dickinson D et al (2008) Galantamine for the treatment of cognitive impairments in people with schizophrenia. Am J Psychiatry 165:82–89CrossRefPubMed
12.
Zurück zum Zitat Carpenter WT, Gold JM (2002) Another view of therapy for cognition in schizophrenia. Biol Psychiatry 51:969–971CrossRefPubMed Carpenter WT, Gold JM (2002) Another view of therapy for cognition in schizophrenia. Biol Psychiatry 51:969–971CrossRefPubMed
13.
Zurück zum Zitat Chamberlain SR, Muller U, Blackwell AD et al (2006) Noradrenergic modulation of working memory and emotional memory in humans. Psychopharmacology 188:397–407CrossRefPubMed Chamberlain SR, Muller U, Blackwell AD et al (2006) Noradrenergic modulation of working memory and emotional memory in humans. Psychopharmacology 188:397–407CrossRefPubMed
14.
Zurück zum Zitat Cooper NJ, Keage H, Hermens D et al (2005) The dose-dependent effect of methylphenidate on performance, cognition and psychophysiology. J Integr Neurosci 4:123–144CrossRefPubMed Cooper NJ, Keage H, Hermens D et al (2005) The dose-dependent effect of methylphenidate on performance, cognition and psychophysiology. J Integr Neurosci 4:123–144CrossRefPubMed
15.
Zurück zum Zitat Coyle JT, Tsai G (2004) The NMDA receptor glycine modulatory site: a therapeutic target for improving cognition and reducing negative symptoms in schizophrenia. Psychopharmacology 174:32–38CrossRefPubMed Coyle JT, Tsai G (2004) The NMDA receptor glycine modulatory site: a therapeutic target for improving cognition and reducing negative symptoms in schizophrenia. Psychopharmacology 174:32–38CrossRefPubMed
16.
Zurück zum Zitat Daniel E, Weinberger D, Goldberg T et al (1991) Effect of amphetamine on regional blood flow during cognitive activation in schizophrenia. J Neurosci 11:1907–1917PubMed Daniel E, Weinberger D, Goldberg T et al (1991) Effect of amphetamine on regional blood flow during cognitive activation in schizophrenia. J Neurosci 11:1907–1917PubMed
17.
Zurück zum Zitat Davidson M, Galderisi S, Weiser M et al (2009) Cognitive effects of antipsychotic drugs in first-episode schizophrenia and schizophreniform disorder: a randomized, open-label clinical trial (EUFEST). Am J Psychiatry 166:675–682CrossRefPubMed Davidson M, Galderisi S, Weiser M et al (2009) Cognitive effects of antipsychotic drugs in first-episode schizophrenia and schizophreniform disorder: a randomized, open-label clinical trial (EUFEST). Am J Psychiatry 166:675–682CrossRefPubMed
18.
Zurück zum Zitat Davidson M, Harvey P, Bergamn R (1990) Effects of the D1 agonist SKF-39393 combined with haloperidol in schizophrenic patients (letter). Arch Gen Psychiatry 47:190–191PubMed Davidson M, Harvey P, Bergamn R (1990) Effects of the D1 agonist SKF-39393 combined with haloperidol in schizophrenic patients (letter). Arch Gen Psychiatry 47:190–191PubMed
19.
Zurück zum Zitat Delle Chiaie R, Salviati M, Fiorentini S et al (2007) Add-on mirtazapine enhances effects on cognition in schizophrenic patients under stabilized treatment with clozapine. Exp Clin Psychopharmacol 15:563–568CrossRef Delle Chiaie R, Salviati M, Fiorentini S et al (2007) Add-on mirtazapine enhances effects on cognition in schizophrenic patients under stabilized treatment with clozapine. Exp Clin Psychopharmacol 15:563–568CrossRef
20.
Zurück zum Zitat Doruk A, Uzun O, Ozsahin A (2008) A placebo-controlled study of extract of ginkgo biloba added to clozapine in patients with treatment-resistant schizophrenia. Int Clin Psychopharmacol 23:223–227CrossRefPubMed Doruk A, Uzun O, Ozsahin A (2008) A placebo-controlled study of extract of ginkgo biloba added to clozapine in patients with treatment-resistant schizophrenia. Int Clin Psychopharmacol 23:223–227CrossRefPubMed
21.
Zurück zum Zitat Elie D, Poirier M, Chianetta J et al (2009) Cognitive effects of antipsychotic dosage and polypharmacy: a study with the BACS in patients with schizophrenia and schizoaffective disorder. J Psychopharmacol Elie D, Poirier M, Chianetta J et al (2009) Cognitive effects of antipsychotic dosage and polypharmacy: a study with the BACS in patients with schizophrenia and schizoaffective disorder. J Psychopharmacol
22.
Zurück zum Zitat Ferreri F, Agbokou C, Gauthier S (2006) Cognitive dysfunctions in schizophrenia: potential benefits of cholinesterase inhibitor adjunctive therapy. J Psychiatry Neurosci 31:369–376PubMed Ferreri F, Agbokou C, Gauthier S (2006) Cognitive dysfunctions in schizophrenia: potential benefits of cholinesterase inhibitor adjunctive therapy. J Psychiatry Neurosci 31:369–376PubMed
23.
Zurück zum Zitat Fletcher PC, Frith CD, Grasby PM et al (1996) Local and distributed effects of apomorphine on fronto-temporal function in acute unmedicated schizophrenia. J Neurosci 16:7055–7062PubMed Fletcher PC, Frith CD, Grasby PM et al (1996) Local and distributed effects of apomorphine on fronto-temporal function in acute unmedicated schizophrenia. J Neurosci 16:7055–7062PubMed
24.
Zurück zum Zitat Freedman R, Olincy A, Buchanan RW et al (2008) Initial phase 2 trial of a nicotinic agonist in schizophrenia. Am J Psychiatry 165:1040–1047CrossRefPubMed Freedman R, Olincy A, Buchanan RW et al (2008) Initial phase 2 trial of a nicotinic agonist in schizophrenia. Am J Psychiatry 165:1040–1047CrossRefPubMed
25.
Zurück zum Zitat Friedman JI (2004) Cholinergic targets for cognitive enhancement in schizophrenia: focus on cholinesterase inhibitors and muscarinic agonists. Psychopharmacology 174:45–53CrossRefPubMed Friedman JI (2004) Cholinergic targets for cognitive enhancement in schizophrenia: focus on cholinesterase inhibitors and muscarinic agonists. Psychopharmacology 174:45–53CrossRefPubMed
26.
Zurück zum Zitat Friedman JI, Adler DN, Temporini HD et al (2001) Guanfacine treatment of cognitive impairment in schizophrenia. Neuropsychopharmacology 25:402–409CrossRefPubMed Friedman JI, Adler DN, Temporini HD et al (2001) Guanfacine treatment of cognitive impairment in schizophrenia. Neuropsychopharmacology 25:402–409CrossRefPubMed
27.
Zurück zum Zitat Friedman JI, Carpenter D, Lu J et al (2008) A pilot study of adjunctive atomoxetine treatment to second-generation antipsychotics for cognitive impairment in schizophrenia. J Clin Psychopharmacol 28:59–63CrossRefPubMed Friedman JI, Carpenter D, Lu J et al (2008) A pilot study of adjunctive atomoxetine treatment to second-generation antipsychotics for cognitive impairment in schizophrenia. J Clin Psychopharmacol 28:59–63CrossRefPubMed
28.
Zurück zum Zitat Friedman JI, Ocampo R, Elbaz Z et al (2005) The effect of citalopram adjunctive treatment added to atypical antipsychotic medications for cognitive performance in patients with schizophrenia. J Clin Psychopharmacol 25:237–242CrossRefPubMed Friedman JI, Ocampo R, Elbaz Z et al (2005) The effect of citalopram adjunctive treatment added to atypical antipsychotic medications for cognitive performance in patients with schizophrenia. J Clin Psychopharmacol 25:237–242CrossRefPubMed
29.
Zurück zum Zitat Frith CD, Mcginty MA, Gergel I et al (1989) The effects of scopolamine and clonidine upon the performance and learning of a motor skill. Psychopharmacology 98:120–125CrossRefPubMed Frith CD, Mcginty MA, Gergel I et al (1989) The effects of scopolamine and clonidine upon the performance and learning of a motor skill. Psychopharmacology 98:120–125CrossRefPubMed
30.
Zurück zum Zitat Ghoneim MM, Block RI, Ping ST et al (1993) The interactions of midazolam and flumazenil on human memory and cognition. Anesthesiology 79:1183–1192CrossRefPubMed Ghoneim MM, Block RI, Ping ST et al (1993) The interactions of midazolam and flumazenil on human memory and cognition. Anesthesiology 79:1183–1192CrossRefPubMed
31.
Zurück zum Zitat Goff D C, Cather C, Gottlieb J D et al. (2008) Once-weekly d-cycloserine effects on negative symptoms and cognition in schizophrenia: An exploratory study. Schizophr Res 106(2–3):320–327 Goff D C, Cather C, Gottlieb J D et al. (2008) Once-weekly d-cycloserine effects on negative symptoms and cognition in schizophrenia: An exploratory study. Schizophr Res 106(2–3):320–327
32.
Zurück zum Zitat Goff DC, Tsai G, Levitt J et al (1999) A placebo-controlled trial of D-cycloserine added to conventional neuroleptics in patients with schizophrenia. Arch Gen Psychiatry 56:21–27CrossRefPubMed Goff DC, Tsai G, Levitt J et al (1999) A placebo-controlled trial of D-cycloserine added to conventional neuroleptics in patients with schizophrenia. Arch Gen Psychiatry 56:21–27CrossRefPubMed
33.
Zurück zum Zitat Goff DC, Lamberti JS, Leon AC et al (2008) A placebo-controlled add-on trial of the Ampakine, CX516, for cognitive deficits in schizophrenia. Neuropsychopharmacology 33:465–472CrossRefPubMed Goff DC, Lamberti JS, Leon AC et al (2008) A placebo-controlled add-on trial of the Ampakine, CX516, for cognitive deficits in schizophrenia. Neuropsychopharmacology 33:465–472CrossRefPubMed
34.
Zurück zum Zitat Goldberg TE, Bigelow LB, Weinberger DR et al (1991) Cognitive and behavioral effects of the coadministration of dextroamphetamine and haloperidol in schizophrenia. Am J Psychiatry 148:78–84PubMed Goldberg TE, Bigelow LB, Weinberger DR et al (1991) Cognitive and behavioral effects of the coadministration of dextroamphetamine and haloperidol in schizophrenia. Am J Psychiatry 148:78–84PubMed
35.
Zurück zum Zitat Goldberg TE, Goldman RS, Burdick KE et al (2007) Cognitive improvement after treatment with second-generation antipsychotic medications in first-episode schizophrenia: is it a practice effect? Arch Gen Psychiatry 64:1115–1122CrossRefPubMed Goldberg TE, Goldman RS, Burdick KE et al (2007) Cognitive improvement after treatment with second-generation antipsychotic medications in first-episode schizophrenia: is it a practice effect? Arch Gen Psychiatry 64:1115–1122CrossRefPubMed
36.
Zurück zum Zitat Goldberg TE, Weinberger DR (1996) Effects of neuroleptic medications on the cognition of patients with schizophrenia: a review of recent studies. J Clin Psychiatry 57 [Suppl 9]:62–65 Goldberg TE, Weinberger DR (1996) Effects of neuroleptic medications on the cognition of patients with schizophrenia: a review of recent studies. J Clin Psychiatry 57 [Suppl 9]:62–65
37.
Zurück zum Zitat Grasby PM, Frith CD, Paulesu E et al (1995) The effect of the muscarinic antagonist scopolamine on regional cerebral blood flow during the performance of a memory task. Exp Brain Res 104:337–348CrossRefPubMed Grasby PM, Frith CD, Paulesu E et al (1995) The effect of the muscarinic antagonist scopolamine on regional cerebral blood flow during the performance of a memory task. Exp Brain Res 104:337–348CrossRefPubMed
38.
Zurück zum Zitat Green MF, Kern RS, Heaton RK (2004) Longitudinal studies of cognition and functional outcome in schizophrenia: implications for MATRICS. Schizophr Res 72:41–51CrossRefPubMed Green MF, Kern RS, Heaton RK (2004) Longitudinal studies of cognition and functional outcome in schizophrenia: implications for MATRICS. Schizophr Res 72:41–51CrossRefPubMed
39.
Zurück zum Zitat Green MF, Marder SR, Glynn S M et al (2002) The neurocognitive effects of low-dose haloperidol: a two-year comparison with risperidone. Biol Psychiatry 51:972–978CrossRefPubMed Green MF, Marder SR, Glynn S M et al (2002) The neurocognitive effects of low-dose haloperidol: a two-year comparison with risperidone. Biol Psychiatry 51:972–978CrossRefPubMed
40.
Zurück zum Zitat Green MF, Marshall JBD, Wirshing WC et al (1997) Does Risperdone improve verbal working memory in treatment-resistant schizophrenia? Am J Psychiatry 154:799–803PubMed Green MF, Marshall JBD, Wirshing WC et al (1997) Does Risperdone improve verbal working memory in treatment-resistant schizophrenia? Am J Psychiatry 154:799–803PubMed
41.
Zurück zum Zitat Hagger C, Buckley P, Kenny JT et al (1993) Improvement in cognitive functions and psychiatric symptoms in treatment-refractory schizophrenic patients receiving clozapine. Biol Psychiatry 34:702–712CrossRefPubMed Hagger C, Buckley P, Kenny JT et al (1993) Improvement in cognitive functions and psychiatric symptoms in treatment-refractory schizophrenic patients receiving clozapine. Biol Psychiatry 34:702–712CrossRefPubMed
42.
Zurück zum Zitat Hall H, Sedvall G, Magnusson O et al (1994) Distribution of D1- and D2-dopamine receptors, and dopamine and its metabolites in the human brain. Neuropsychopharmacology 11:245–256PubMed Hall H, Sedvall G, Magnusson O et al (1994) Distribution of D1- and D2-dopamine receptors, and dopamine and its metabolites in the human brain. Neuropsychopharmacology 11:245–256PubMed
43.
44.
Zurück zum Zitat Hashimoto T, Volk DW, Eggan SM et al (2003) Gene expression deficits in a subclass of GABA neurons in the prefrontal cortex of subjects with schizophrenia. J Neurosci 23:6315–6326PubMed Hashimoto T, Volk DW, Eggan SM et al (2003) Gene expression deficits in a subclass of GABA neurons in the prefrontal cortex of subjects with schizophrenia. J Neurosci 23:6315–6326PubMed
45.
Zurück zum Zitat Heresco-Levy U, Javitt DC, Ermilov M et al (1996) Double-blind, placebo-controlled, crossover trial of glycine adjuvant therapy for treatment-resistant schizophrenia. Br J Psychiatry 169:610–617CrossRefPubMed Heresco-Levy U, Javitt DC, Ermilov M et al (1996) Double-blind, placebo-controlled, crossover trial of glycine adjuvant therapy for treatment-resistant schizophrenia. Br J Psychiatry 169:610–617CrossRefPubMed
46.
Zurück zum Zitat Hirst WD, Stean TO, Rogers DC et al (2006) SB-399885 is a potent, selective 5-HT6 receptor antagonist with cognitive enhancing properties in aged rat water maze and novel object recognition models. Eur J Pharmacol 553:109–119CrossRefPubMed Hirst WD, Stean TO, Rogers DC et al (2006) SB-399885 is a potent, selective 5-HT6 receptor antagonist with cognitive enhancing properties in aged rat water maze and novel object recognition models. Eur J Pharmacol 553:109–119CrossRefPubMed
47.
Zurück zum Zitat Hunter MD, Ganesan V, Wilkinson ID et al (2006) Impact of modafinil on prefrontal executive function in schizophrenia. Am J Psychiatry 163:2184–2186CrossRefPubMed Hunter MD, Ganesan V, Wilkinson ID et al (2006) Impact of modafinil on prefrontal executive function in schizophrenia. Am J Psychiatry 163:2184–2186CrossRefPubMed
48.
Zurück zum Zitat Javitt DC (2007) Glutamate and schizophrenia: phencyclidine, n-methyl-d-aspartate receptors, and dopamine-glutamate interactions. Int Rev Neurobiol 78:69–108CrossRefPubMed Javitt DC (2007) Glutamate and schizophrenia: phencyclidine, n-methyl-d-aspartate receptors, and dopamine-glutamate interactions. Int Rev Neurobiol 78:69–108CrossRefPubMed
49.
Zurück zum Zitat Jones PB, Barnes TR, Davies L et al (2006) Randomized controlled trial of the effect on Quality of Life of second- vs first-generation antipsychotic drugs in schizophrenia: Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study (CUtLASS 1). Arch Gen Psychiatry 63:1079–1087CrossRefPubMed Jones PB, Barnes TR, Davies L et al (2006) Randomized controlled trial of the effect on Quality of Life of second- vs first-generation antipsychotic drugs in schizophrenia: Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study (CUtLASS 1). Arch Gen Psychiatry 63:1079–1087CrossRefPubMed
50.
Zurück zum Zitat Keefe RS, Bilder RM, Davis SM et al (2007) Neurocognitive effects of antipsychotic medications in patients with chronic schizophrenia in the CATIE Trial. Arch Gen Psychiatry 64:633–647CrossRefPubMed Keefe RS, Bilder RM, Davis SM et al (2007) Neurocognitive effects of antipsychotic medications in patients with chronic schizophrenia in the CATIE Trial. Arch Gen Psychiatry 64:633–647CrossRefPubMed
51.
Zurück zum Zitat Keefe RS, Silva SG, Perkins DO et al (1999) The effects of atypical antipsychotic drugs on neurocognitive impairment in schizophrenia: a review and meta-analysis. Schizophr Bull 25:201–222PubMed Keefe RS, Silva SG, Perkins DO et al (1999) The effects of atypical antipsychotic drugs on neurocognitive impairment in schizophrenia: a review and meta-analysis. Schizophr Bull 25:201–222PubMed
52.
Zurück zum Zitat Kern RS, Glynn SM, Horan WP et al (2009) Psychosocial treatments to promote functional recovery in schizophrenia. Schizophr Bull 35:347–361CrossRefPubMed Kern RS, Glynn SM, Horan WP et al (2009) Psychosocial treatments to promote functional recovery in schizophrenia. Schizophr Bull 35:347–361CrossRefPubMed
53.
Zurück zum Zitat Knoflach F, Mutel V, Jolidon S et al (2001) Positive allosteric modulators of metabotropic glutamate 1 receptor: characterization, mechanism of action, and binding site. Proc Natl Acad Sci U S A 98:13402–13407CrossRefPubMed Knoflach F, Mutel V, Jolidon S et al (2001) Positive allosteric modulators of metabotropic glutamate 1 receptor: characterization, mechanism of action, and binding site. Proc Natl Acad Sci U S A 98:13402–13407CrossRefPubMed
54.
Zurück zum Zitat Koike K, Hashimoto K, Takai N et al (2005) Tropisetron improves deficits in auditory P50 suppression in schizophrenia. Schizophr Res 76:67–72CrossRefPubMed Koike K, Hashimoto K, Takai N et al (2005) Tropisetron improves deficits in auditory P50 suppression in schizophrenia. Schizophr Res 76:67–72CrossRefPubMed
55.
Zurück zum Zitat Krystal JH, Karper LP, Bennett A et al (1998) Interactive effects of subanesthetic ketamine and subhypnotic lorazepam in humans. Psychopharmacology 135:213–229CrossRefPubMed Krystal JH, Karper LP, Bennett A et al (1998) Interactive effects of subanesthetic ketamine and subhypnotic lorazepam in humans. Psychopharmacology 135:213–229CrossRefPubMed
56.
Zurück zum Zitat Krystal JH, Karper LP, Seibyl JP et al (1994) Subanesthetic effects of the noncompetitive NMDA antagonist, ketamine, in humans. Psychotomimetic, perceptual, cognitive, and neuroendocrine responses. Arch Gen Psychiatry 51:199–214PubMed Krystal JH, Karper LP, Seibyl JP et al (1994) Subanesthetic effects of the noncompetitive NMDA antagonist, ketamine, in humans. Psychotomimetic, perceptual, cognitive, and neuroendocrine responses. Arch Gen Psychiatry 51:199–214PubMed
57.
Zurück zum Zitat Lewis DA, Cho RY, Carter CS et al (2008) Subunit-selective modulation of GABA Type A receptor neurotransmission and cognition in schizophrenia. Am J Psychiatry 165(12):1585–1593CrossRefPubMed Lewis DA, Cho RY, Carter CS et al (2008) Subunit-selective modulation of GABA Type A receptor neurotransmission and cognition in schizophrenia. Am J Psychiatry 165(12):1585–1593CrossRefPubMed
58.
Zurück zum Zitat Lucas PB, Pickar D, Kelsoe J et al (1990) Effects of the acute administration of caffeine in patients with schizophrenia. Biol Psychiatry 28:35–40CrossRefPubMed Lucas PB, Pickar D, Kelsoe J et al (1990) Effects of the acute administration of caffeine in patients with schizophrenia. Biol Psychiatry 28:35–40CrossRefPubMed
59.
Zurück zum Zitat Medalia A, Gold J, Merriam A (1988) The effects of neuroleptics on neuropsychological test results of schizophrenics. Arch Clin Neuropsychol 3:249–271PubMed Medalia A, Gold J, Merriam A (1988) The effects of neuroleptics on neuropsychological test results of schizophrenics. Arch Clin Neuropsychol 3:249–271PubMed
60.
Zurück zum Zitat Meltzer HY, Mcgurk SR (1999) The effects of clozapine, risperidone, and olanzapine on cognitive function in schizophrenia. Schizophr Bull 25:233–255PubMed Meltzer HY, Mcgurk SR (1999) The effects of clozapine, risperidone, and olanzapine on cognitive function in schizophrenia. Schizophr Bull 25:233–255PubMed
61.
Zurück zum Zitat Meltzer HY, Sumiyoshi T (2008) Does stimulation of 5-HT(1A) receptors improve cognition in schizophrenia? Behav Brain Res 195:98–102CrossRefPubMed Meltzer HY, Sumiyoshi T (2008) Does stimulation of 5-HT(1A) receptors improve cognition in schizophrenia? Behav Brain Res 195:98–102CrossRefPubMed
62.
Zurück zum Zitat Menzies L, Ooi C, Kamath S et al (2007) Effects of gamma-aminobutyric acid-modulating drugs on working memory and brain function in patients with schizophrenia. Arch Gen Psychiatry 64:156–167CrossRefPubMed Menzies L, Ooi C, Kamath S et al (2007) Effects of gamma-aminobutyric acid-modulating drugs on working memory and brain function in patients with schizophrenia. Arch Gen Psychiatry 64:156–167CrossRefPubMed
63.
Zurück zum Zitat Minzenberg MJ, Carter CS (2008) Modafinil: a review of neurochemical actions and effects on cognition. Neuropsychopharmacology 33:1477–1502CrossRefPubMed Minzenberg MJ, Carter CS (2008) Modafinil: a review of neurochemical actions and effects on cognition. Neuropsychopharmacology 33:1477–1502CrossRefPubMed
64.
Zurück zum Zitat Mishara AL, Goldberg TE (2004) A meta-analysis and critical review of the effects of conventional neuroleptic treatment on cognition in schizophrenia: opening a closed book. Biol Psychiatry 55:1013–1022CrossRefPubMed Mishara AL, Goldberg TE (2004) A meta-analysis and critical review of the effects of conventional neuroleptic treatment on cognition in schizophrenia: opening a closed book. Biol Psychiatry 55:1013–1022CrossRefPubMed
65.
Zurück zum Zitat Morein-Zamir S, Turner DC, Sahakian BJ (2007) A review of the effects of modafinil on cognition in schizophrenia. Schizophr Bull 33:1298–1306CrossRefPubMed Morein-Zamir S, Turner DC, Sahakian BJ (2007) A review of the effects of modafinil on cognition in schizophrenia. Schizophr Bull 33:1298–1306CrossRefPubMed
66.
Zurück zum Zitat Morgan CJ, Curran HV (2008) Effects of cannabidiol on schizophrenia-like symptoms in people who use cannabis. Br J Psychiatry 192:306–307CrossRefPubMed Morgan CJ, Curran HV (2008) Effects of cannabidiol on schizophrenia-like symptoms in people who use cannabis. Br J Psychiatry 192:306–307CrossRefPubMed
67.
Zurück zum Zitat Müller U, Becker T (2008) Kognition und Rehabilitation. In: Kircher T, Gauggel S (eds) Neuropsychologie der Schizophrenie: Symptome, Kognition, Gehirn. Springer, Heidelberg Müller U, Becker T (2008) Kognition und Rehabilitation. In: Kircher T, Gauggel S (eds) Neuropsychologie der Schizophrenie: Symptome, Kognition, Gehirn. Springer, Heidelberg
68.
Zurück zum Zitat Müller U, Mottweiler E, Bublak P (2005) Noradrenergic blockade and numeric working memory in humans. J Psychopharmacol 19:21–28CrossRefPubMed Müller U, Mottweiler E, Bublak P (2005) Noradrenergic blockade and numeric working memory in humans. J Psychopharmacol 19:21–28CrossRefPubMed
69.
Zurück zum Zitat Müller U, Steffenhagen N, Regenthal R et al (2004) Effects of modafinil on working memory processes in humans. Psychopharmacology 177:161–169CrossRefPubMed Müller U, Steffenhagen N, Regenthal R et al (2004) Effects of modafinil on working memory processes in humans. Psychopharmacology 177:161–169CrossRefPubMed
70.
Zurück zum Zitat Müller U, Yves D, Pollman S (1998) D1-Versus D2-receptor modulation of visualspatial working memory in humans. J Neurosci 18:2720–2728PubMed Müller U, Yves D, Pollman S (1998) D1-Versus D2-receptor modulation of visualspatial working memory in humans. J Neurosci 18:2720–2728PubMed
71.
Zurück zum Zitat Noorbala AA, Akhondzadeh S, Davari-Ashtiani R et al (1999) Piracetam in the treatment of schizophrenia: implications for the glutamate hypothesis of schizophrenia. J Clin Pharm Ther 24:369–374CrossRefPubMed Noorbala AA, Akhondzadeh S, Davari-Ashtiani R et al (1999) Piracetam in the treatment of schizophrenia: implications for the glutamate hypothesis of schizophrenia. J Clin Pharm Ther 24:369–374CrossRefPubMed
72.
Zurück zum Zitat O’Neill MJ, Bleakman D, Zimmerman DM et al (2004) AMPA receptor potentiators for the treatment of CNS disorders. Curr Drug Targets CNS Neurol Disord 3:181–194CrossRef O’Neill MJ, Bleakman D, Zimmerman DM et al (2004) AMPA receptor potentiators for the treatment of CNS disorders. Curr Drug Targets CNS Neurol Disord 3:181–194CrossRef
73.
Zurück zum Zitat Poyurovsky M, Koren D, Gonopolsky I et al (2003) Effect of the 5-HT2 antagonist mianserin on cognitive dysfunction in chronic schizophrenia patients: an add-on, double-blind placebo-controlled study. Eur Neuropsychopharmacol 13:123–128CrossRefPubMed Poyurovsky M, Koren D, Gonopolsky I et al (2003) Effect of the 5-HT2 antagonist mianserin on cognitive dysfunction in chronic schizophrenia patients: an add-on, double-blind placebo-controlled study. Eur Neuropsychopharmacol 13:123–128CrossRefPubMed
74.
Zurück zum Zitat Purdon SE, Woodward N, Lindborg SR et al (2003) Procedural learning in schizophrenia after 6 months of double-blind treatment with olanzapine, risperidone, and haloperidol. Psychopharmacology 169:390–397CrossRefPubMed Purdon SE, Woodward N, Lindborg SR et al (2003) Procedural learning in schizophrenia after 6 months of double-blind treatment with olanzapine, risperidone, and haloperidol. Psychopharmacology 169:390–397CrossRefPubMed
75.
Zurück zum Zitat Raedler TJ, Jahn H, Arlt J et al (2004) Adjunctive use of reboxetine in schizophrenia. Eur Psychiatry 19:366–369CrossRefPubMed Raedler TJ, Jahn H, Arlt J et al (2004) Adjunctive use of reboxetine in schizophrenia. Eur Psychiatry 19:366–369CrossRefPubMed
76.
Zurück zum Zitat Rockstroh S, Emre M, Tarral A et al (1996) Effects of the novel NMDA-receptor antagonist SDZ EAA 494 on memory and attention in humans. Psychopharmacology 124:261–266CrossRefPubMed Rockstroh S, Emre M, Tarral A et al (1996) Effects of the novel NMDA-receptor antagonist SDZ EAA 494 on memory and attention in humans. Psychopharmacology 124:261–266CrossRefPubMed
77.
Zurück zum Zitat Roesch-Ely D, Gohring K, Gruschka P et al (2006) Pergolide as adjuvant therapy to amisulpride in the treatment of negative and depressive symptoms in schizophrenia. Pharmacopsychiatry 39:115–116CrossRefPubMed Roesch-Ely D, Gohring K, Gruschka P et al (2006) Pergolide as adjuvant therapy to amisulpride in the treatment of negative and depressive symptoms in schizophrenia. Pharmacopsychiatry 39:115–116CrossRefPubMed
78.
Zurück zum Zitat Roesch-Ely D, Scheffel H, Weiland S et al (2005) Differential dopaminergic modulation of executive control in healthy subjects. Psychopharmacology 178:420–430CrossRefPubMed Roesch-Ely D, Scheffel H, Weiland S et al (2005) Differential dopaminergic modulation of executive control in healthy subjects. Psychopharmacology 178:420–430CrossRefPubMed
79.
Zurück zum Zitat Roesch-Ely D, Weiland S, Scheffel H et al (2006) Dopaminergic modulation of semantic priming in healthy volunteers. Biol Psychiatry 60:604–611CrossRefPubMed Roesch-Ely D, Weiland S, Scheffel H et al (2006) Dopaminergic modulation of semantic priming in healthy volunteers. Biol Psychiatry 60:604–611CrossRefPubMed
80.
Zurück zum Zitat Roth BL, Hanizavareh SM, Blum AE (2004) Serotonin receptors represent highly favorable molecular targets for cognitive enhancement in schizophrenia and other disorders. Psychopharmacology 174:17–24CrossRefPubMed Roth BL, Hanizavareh SM, Blum AE (2004) Serotonin receptors represent highly favorable molecular targets for cognitive enhancement in schizophrenia and other disorders. Psychopharmacology 174:17–24CrossRefPubMed
81.
Zurück zum Zitat Sacco KA, Creeden C, Reutenauer EL et al (2008) Effects of atomoxetine on cognitive function and cigarette smoking in schizophrenia. Schizophr Res Sacco KA, Creeden C, Reutenauer EL et al (2008) Effects of atomoxetine on cognitive function and cigarette smoking in schizophrenia. Schizophr Res
82.
Zurück zum Zitat Sawaguchi T, Goldman-Rakic PS (1991) D1 dopamine receptors in prefrontal cortex: involvement in working memory. Science 251:947–950CrossRefPubMed Sawaguchi T, Goldman-Rakic PS (1991) D1 dopamine receptors in prefrontal cortex: involvement in working memory. Science 251:947–950CrossRefPubMed
83.
Zurück zum Zitat Saykin AJ, Gur RC, Gur RE et al (1991) Neuropsychological function in schizophrenia. Selective impairment in memory and learning. Arch Gen Psychiatry 48:618–624PubMed Saykin AJ, Gur RC, Gur RE et al (1991) Neuropsychological function in schizophrenia. Selective impairment in memory and learning. Arch Gen Psychiatry 48:618–624PubMed
84.
Zurück zum Zitat Sevy S, Rosenthal MH, Alvir J et al (2005) Double-blind, placebo-controlled study of modafinil for fatigue and cognition in schizophrenia patients treated with psychotropic medications. J Clin Psychiatry 66:839–843CrossRefPubMed Sevy S, Rosenthal MH, Alvir J et al (2005) Double-blind, placebo-controlled study of modafinil for fatigue and cognition in schizophrenia patients treated with psychotropic medications. J Clin Psychiatry 66:839–843CrossRefPubMed
85.
Zurück zum Zitat Shekhar A, Potter WZ, Lightfoot J et al (2008) Selective muscarinic receptor agonist xanomeline as a novel treatment approach for schizophrenia. Am J Psychiatry 165:1033–1039CrossRefPubMed Shekhar A, Potter WZ, Lightfoot J et al (2008) Selective muscarinic receptor agonist xanomeline as a novel treatment approach for schizophrenia. Am J Psychiatry 165:1033–1039CrossRefPubMed
86.
Zurück zum Zitat Siepmann M, Muck-Weymann M, Joraschky P et al (2001) The effects of reboxetine on autonomic and cognitive functions in healthy volunteers. Psychopharmacology 157:202–207CrossRefPubMed Siepmann M, Muck-Weymann M, Joraschky P et al (2001) The effects of reboxetine on autonomic and cognitive functions in healthy volunteers. Psychopharmacology 157:202–207CrossRefPubMed
87.
Zurück zum Zitat Smith RC, Warner-Cohen J, Matute M et al (2006) Effects of nicotine nasal spray on cognitive function in schizophrenia. Neuropsychopharmacology 31:637–643CrossRefPubMed Smith RC, Warner-Cohen J, Matute M et al (2006) Effects of nicotine nasal spray on cognitive function in schizophrenia. Neuropsychopharmacology 31:637–643CrossRefPubMed
88.
Zurück zum Zitat Spence SA, Green RD, Wilkinson ID et al (2005) Modafinil modulates anterior cingulate function in chronic schizophrenia. Br J Psychiatry 187:55–61CrossRefPubMed Spence SA, Green RD, Wilkinson ID et al (2005) Modafinil modulates anterior cingulate function in chronic schizophrenia. Br J Psychiatry 187:55–61CrossRefPubMed
89.
Zurück zum Zitat Spring B, Gelenberg AJ, Garvin R et al (1992) Amitriptyline, clovoxamine and cognitive function: a placebo-controlled comparison in depressed outpatients. Psychopharmacology 108:327–332CrossRefPubMed Spring B, Gelenberg AJ, Garvin R et al (1992) Amitriptyline, clovoxamine and cognitive function: a placebo-controlled comparison in depressed outpatients. Psychopharmacology 108:327–332CrossRefPubMed
90.
Zurück zum Zitat Strassnig M, Brar JS, Ganguli R (2006) Increased caffeine and nicotine consumption in community-dwelling patients with schizophrenia. Schizophr Res 86:269–275CrossRefPubMed Strassnig M, Brar JS, Ganguli R (2006) Increased caffeine and nicotine consumption in community-dwelling patients with schizophrenia. Schizophr Res 86:269–275CrossRefPubMed
91.
Zurück zum Zitat Strauss ME, Reynolds KS, Jayaram G et al (1990) Effects of anticholinergic medication on memory in schizophrenia. Schizophr Res 3:127–129CrossRefPubMed Strauss ME, Reynolds KS, Jayaram G et al (1990) Effects of anticholinergic medication on memory in schizophrenia. Schizophr Res 3:127–129CrossRefPubMed
92.
Zurück zum Zitat Sumiyoshi T, Matsui M, Nohara S et al (2001) Enhancement of cognitive performance in schizophrenia by addition of tandospirone to neuroleptic treatment. Am J Psychiatry 158:1722–1725CrossRefPubMed Sumiyoshi T, Matsui M, Nohara S et al (2001) Enhancement of cognitive performance in schizophrenia by addition of tandospirone to neuroleptic treatment. Am J Psychiatry 158:1722–1725CrossRefPubMed
93.
Zurück zum Zitat Sumiyoshi T, Park S, Jayathilake K et al (2007) Effect of buspirone, a serotonin1A partial agonist, on cognitive function in schizophrenia: a randomized, double-blind, placebo-controlled study. Schizophr Res 95:158–168CrossRefPubMed Sumiyoshi T, Park S, Jayathilake K et al (2007) Effect of buspirone, a serotonin1A partial agonist, on cognitive function in schizophrenia: a randomized, double-blind, placebo-controlled study. Schizophr Res 95:158–168CrossRefPubMed
94.
Zurück zum Zitat Szeszko PR, Bilder RM, Dunlop JA et al (1999) Longitudinal assessment of methylphenidate effects on oral word production and symptoms in first-episode schizophrenia at acute and stabilized phases. Biol Psychiatry 45:680–686CrossRefPubMed Szeszko PR, Bilder RM, Dunlop JA et al (1999) Longitudinal assessment of methylphenidate effects on oral word production and symptoms in first-episode schizophrenia at acute and stabilized phases. Biol Psychiatry 45:680–686CrossRefPubMed
95.
96.
Zurück zum Zitat Thiel CM (2003) Cholinergic modulation of learning and memory in the human brain as detected with functional neuroimaging. Neurobiol Learn Mem 80:234–244CrossRefPubMed Thiel CM (2003) Cholinergic modulation of learning and memory in the human brain as detected with functional neuroimaging. Neurobiol Learn Mem 80:234–244CrossRefPubMed
97.
Zurück zum Zitat Turner DC, Clark L, Pomarol-Clotet E et al (2004) Modafinil improves cognition and attentional set shifting in patients with chronic schizophrenia. Neuropsychopharmacology 29:1363–1373CrossRefPubMed Turner DC, Clark L, Pomarol-Clotet E et al (2004) Modafinil improves cognition and attentional set shifting in patients with chronic schizophrenia. Neuropsychopharmacology 29:1363–1373CrossRefPubMed
98.
Zurück zum Zitat Turner DC, Robbins TW, Clark L et al (2003) Cognitive enhancing effects of modafinil in healthy volunteers. Psychopharmacology 165:260–269PubMed Turner DC, Robbins TW, Clark L et al (2003) Cognitive enhancing effects of modafinil in healthy volunteers. Psychopharmacology 165:260–269PubMed
99.
Zurück zum Zitat Voss B, Thienel R, Leucht S et al (2008) Therapy of cognitive deficits in schizophrenia with acetylcholinesterase inhibitors. A systematic overview. Nervenarzt 79:47–48, 50–42, 54–49CrossRefPubMed Voss B, Thienel R, Leucht S et al (2008) Therapy of cognitive deficits in schizophrenia with acetylcholinesterase inhibitors. A systematic overview. Nervenarzt 79:47–48, 50–42, 54–49CrossRefPubMed
100.
Zurück zum Zitat Wagner M, Quednow BB, Westheide J et al (2005) Cognitive improvement in schizophrenic patients does not require a serotonergic mechanism: randomized controlled trial of olanzapine vs amisulpride. Neuropsychopharmacology 30:381–390CrossRefPubMed Wagner M, Quednow BB, Westheide J et al (2005) Cognitive improvement in schizophrenic patients does not require a serotonergic mechanism: randomized controlled trial of olanzapine vs amisulpride. Neuropsychopharmacology 30:381–390CrossRefPubMed
101.
Zurück zum Zitat Weickert TW, Goldberg TE, Marenco S et al (2003) Comparison of cognitive performances during a placebo period and an atypical antipsychotic treatment period in schizophrenia: critical examination of confounds. Neuropsychopharmacology 28:1491–1500CrossRefPubMed Weickert TW, Goldberg TE, Marenco S et al (2003) Comparison of cognitive performances during a placebo period and an atypical antipsychotic treatment period in schizophrenia: critical examination of confounds. Neuropsychopharmacology 28:1491–1500CrossRefPubMed
102.
Zurück zum Zitat Wingen M, Kuypers KP, Ramaekers JG (2007) Selective verbal and spatial memory impairment after 5-HT1A and 5-HT2A receptor blockade in healthy volunteers pre-treated with an SSRI. J Psychopharmacol 21:477–485CrossRefPubMed Wingen M, Kuypers KP, Ramaekers JG (2007) Selective verbal and spatial memory impairment after 5-HT1A and 5-HT2A receptor blockade in healthy volunteers pre-treated with an SSRI. J Psychopharmacol 21:477–485CrossRefPubMed
103.
Zurück zum Zitat Wittorf A, Sickinger S, Wiedemann G et al (2008) Neurocognitive effects of atypical and conventional antipsychotic drugs in schizophrenia: a naturalistic 6-month follow-up study. Arch Clin Neuropsychol 23:271–282CrossRefPubMed Wittorf A, Sickinger S, Wiedemann G et al (2008) Neurocognitive effects of atypical and conventional antipsychotic drugs in schizophrenia: a naturalistic 6-month follow-up study. Arch Clin Neuropsychol 23:271–282CrossRefPubMed
104.
Zurück zum Zitat Woodward ND, Purdon SE, Meltzer HY et al (2007) A meta-analysis of cognitive change with haloperidol in clinical trials of atypical antipsychotics: dose effects and comparison to practice effects. Schizophr Res 89:211–224CrossRefPubMed Woodward ND, Purdon SE, Meltzer HY et al (2007) A meta-analysis of cognitive change with haloperidol in clinical trials of atypical antipsychotics: dose effects and comparison to practice effects. Schizophr Res 89:211–224CrossRefPubMed
105.
Zurück zum Zitat Woodward ND, Purdon SE, Meltzer HY et al (2005) A meta-analysis of neuropsychological change to clozapine, olanzapine, quetiapine, and risperidone in schizophrenia. Int J Neuropsychopharmacol 8:457–472CrossRefPubMed Woodward ND, Purdon SE, Meltzer HY et al (2005) A meta-analysis of neuropsychological change to clozapine, olanzapine, quetiapine, and risperidone in schizophrenia. Int J Neuropsychopharmacol 8:457–472CrossRefPubMed
Metadaten
Titel
Behandlung kognitiver Defizite bei Schizophrenie
Teil II: Pharmakologische Strategien
verfasst von
Dr. D. Roesch-Ely
U. Pfueller
C. Mundt
U. Müller
M. Weisbrod
Publikationsdatum
01.05.2010
Verlag
Springer-Verlag
Erschienen in
Der Nervenarzt / Ausgabe 5/2010
Print ISSN: 0028-2804
Elektronische ISSN: 1433-0407
DOI
https://doi.org/10.1007/s00115-009-2919-6

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