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Cognitive Effects of Combined Amisulpride and Quetiapine Treatment in Patients With Refractory Schizophrenia

A Naturalistic, Prospective Study

Molina, Juan de Dios MD, PhD1,2,3; Quintero, Javier MD, PhD4; García-Laredo, Eduardo PSYD, PhD5,*; López-Muñoz, Francisco MD, PhD3,6; Correas-Lauffer, Javier MD, PhD7; Barbudo, Eduardo MD, PhD8; Ceverino, Antonio MD, PhD9; Mur, Carlos MD, PhD10; Garcia-Resa, E. MD, PhD11

doi: 10.1097/MJT.0000000000000956
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Background: Regarding the treatment of patients with resistant schizophrenia, different options exit, although they are supported by limited evidence. In this study, antipsychotic polypharmacy, comprising 1200 mg of amisulpride and 600 mg of quetiapine, was used. Clinical change evaluation was performed using neurocognitive evaluations.

Study Question: The use of amisulpride and quetiapine will imply a clinical improvement in patients affected by schizophrenia, which will be specially reflected in a cognitive improvement.

Study Design: Naturalistic and prospective study. Twenty-six patients were applied and assessed by a battery of neurocognitive evaluations since the pretreatment baseline until 6-month treatment. The patients had no biological response to medication, high social maladjustment, and a long clinical history of the disease. Kane and Brenner criteria for treatment-resistant schizophrenia were applied to choose the subjects.

Measures and Outcomes: The cognitive improvement will imply a significant betterment, from the pretreatment baseline until 6-month treatment, in the following cognitive tests: Stroop Test, WAIS Coding Subtest, and Comprehensive Trail Making Test (CTMT). An improvement in the Calgary Depression Scale, Simpson–Angus Scale, and Visual Analogue Scale (EVA) will also be observed. This scales were been used during the baseline, 3 months after, and then, 6 months.

Results: Subjects, after 6-month treatment with amisulpride and quetiapine, did show statistically significant differences in the assessed areas: WAIS Coding Subtest (P < 0.001), CTMT A and B (CTMT A P < 0.034; CTMT B P < 0.000), and Stroop Tests: Word (P < 0.001), Word-Color (P < 0.007), and Interference (P < 0.039). Furthermore, they showed a statistically significant difference in the Calgary Depression Scale (P < 0.002), Simpson–Angus Scale (P < 0.019), and EVA (P < 0.001).

Conclusions: The results of this report show a cognitive and clinical improvement in refractory patients after the administration of amisulpride and quetiapine.

1 Head of Mental Health Center of Villaverde, Service of Psychiatry, Hospital 12 de Octubre ResearchInstitute (i+12), Madrid, Spain;

2Research Center for Mental Health Network (CIBERSAM), Madrid, Spain;

3Faculty of Health Sciences and Criminology Degree, University Francisco de Vitoria (UFV), Madrid, Spain;

4Head of Psychiatry Service, Hospital Infanta Leonor, Madrid, Spain;

5National Distance Education University, UNED, Madrid, Spain;

6Pharmacology Department, University of Alcalá, Madrid, Spain;

7Head of Psychiatry Service, Hospital del Henares, Madrid, Spain;

8Psychiatry Service, Hospital Clínico San Carlos, Madrid, Spain;

9Psychiatry Service, Fundación Jimenez Diaz, Madrid, Spain;

10Hospital Universitario de Fuenlabrada, Madrid, Spain; and

11Mental Health Center of Villena, Hospital General Universitario de Elda, Alicante, Spain.

Address for correspondence: E. García-Laredo, PhD, Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, National Distance Education University, UNED, Jacinto Verdaguer, Calle de Fuente de Lima, 22, Madrid, Spain 28024. E-mail: egarcialaredo@madrid.uned.es

The authors have no conflicts of interest to declare.

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