Comparison of Neurocognitive Effects of Blonanserin, Olanzapine, Aripiprazole, and Risperidone in Drug-Naïve First-Episode Schizophrenia
AI Summary
All four antipsychotics produced comparable improvements in processing speed and working memory over six months in drug-naïve first-episode schizophrenia.
Blonanserin produced greater improvements in verbal learning (p=0.005) and visuospatial memory (p=0.045) compared with risperidone.
Study pooled two trials with 594 recruited and 294 completers; neurocognitive assessment conducted at baseline and six months.
Neuropsychiatr Dis Treat. 2026 May 13;22:603001. doi: 10.2147/NDT.S603001. eCollection 2026.
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.
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