Cognitive enhancing drugs for schizophrenia

Schizophrenia is frequently associated with cognitive deficits that are already present at an early stage of illness. Cognitive deficits in schizophrenia cover a variety of cognitive domains including memory, attention, processing speed, verbal comprehension and problem solving. These cognitive deficits cause subjective distress and significantly impair the level of functioning. Cognitive deficits in schizophrenia do not respond well to antipsychotic treatment.This manuscript reviews novel treatment approaches to enhance cognitive function in schizophrenia. Most of these approaches focus on the neurotransmitters acetylcholine, dopamine and glutamate. Small studies have shown a significant improvement of cognition under treatment with muscarinic and nicotinic agonists. Alternative approaches include agonists and cofactors for different gluatamatergic receptors, glycine transporter inhibitors and dopamine D1 receptor agonists. These novel treatment approaches, while promising from a theoretical perspective, have not yet proven effective in larger clinical studies. Several clinical studies are being conducted currently that will hopefully result in effective and well-tolerated pharmaceuticals, that will improve cognitive function in subjects suffering from schizophrenia.

Section editor:Leslie Iversen – Department of Pharmacology, University of Oxford, UK