Comparison of Neurocognitive Effects of Blonanserin, Olanzapine, Aripiprazole, and Risperidone in Drug-Naïve First-Episode Schizophrenia.

Abstract

Background: Neurocognitive deficits are a core feature of schizophrenia. The specific impact of antipsychotics on neurocognitive function in drug-naïve first-episode schizophrenia (FES) remains unclear, especially for newer agents like blonanserin. This study compared the neurocognitive effects of blonanserin, olanzapine, aripiprazole, and risperidone during the first 6 months of treatment in FES patients.

Study design: Data were derived from two clinical trials in which FES patients received initial treatment with blonanserin, olanzapine, aripiprazole, or risperidone. Neurocognitive function was assessed at baseline and 6 months using multiple measures. Paired t-tests evaluated within-group changes, and repeated measures ANOVA examined differential effects across groups.

Study results: Of 594 recruited patients, 294 completed follow-up. All four groups showed comparable improvements in processing speed and working memory. A significant group-by-time interaction was observed for verbal (p = 0.005) and visuospatial memory (p = 0.054). Notably, blonanserin-treated patients demonstrated greater improvements in verbal learning (p = 0.005) and visuospatial memory (p = 0.045) compared to risperidone.

Conclusion: Initial antipsychotic treatment in drug-naïve FES patients is associated with neurocognitive benefits, particularly in processing speed and working memory. Furthermore, blonanserin may offer advantages in ameliorating learning and memory deficits compared to risperidone.