benztropine and Memory-Disorders

Spatial memory is of interest in schizophrenia because of widespread impairments in adaptive functioning, including independent living skills. Short-term spatial memory is impaired in this disease, whereas spatial reference memory, a longer-term spatial memory, has not been evaluated. Animal studies have demonstrated that anticholinergics impair short-term spatial memory but not spatial reference memory. The effects of haloperidol and risperidone on these two types of spatial memory were evaluated in a double-blind randomized comparison in inpatients with schizophrenia. It was predicted that risperidone would have a greater beneficial effect on spatial working memory than haloperidol. Computerized measures of spatial working memory and spatial reference memory were developed based on animal assessment of these functions. Subjects with schizophrenia were assessed during a medication-free period and again following 4 weeks of fixed-dose treatment. Risperidone, compared to haloperidol, improved spatial working memory performance, an effect that became nonsignificant when benztropine co-treatment was controlled. There were no treatment effects on spatial reference memory performance. Consistent with animal studies, benztropine impaired spatial working memory but not spatial reference memory. The relative benefits of risperidone on spatial working memory performance were largely explained by differential benztropine treatment for the haloperidol-treated subjects.

Topics: Adult; Antipsychotic Agents; Benztropine; Cholinergic Antagonists; Cognition Disorders; Female; Humans; Male; Memory; Memory Disorders; Pattern Recognition, Visual; Psychiatric Status Rating Scales; Psychomotor Performance; Reaction Time; Risperidone; Schizophrenia; Schizophrenic Psychology; Space Perception

Anticholinergic antiparkinson drugs administered orally at standard clinically prescribed doses impaired new memory acquisition and mood in normal volunteer subjects, based on tests of free recall, recognition memory, and time production, self-rating of memory function, and an evaluation of mood states. Elderly subjects were more severely impaired than were young adults. Amantadine did not impair new memory acquisition, and on self-report measures, it was significantly better tolerated than were anticholinergics. Among patients being treated for psychotic illness, there are two groups in which an effort to avoid anticholinergic therapy is especially worthwhile because of the severe consequences of memory dysfunction. These individuals are young neuroleptic-responsive patients who are in an early stage of their disease and elderly patients. For these two groups, amantadine should be considered as the initial mode of treatment, with low-dose anticholinergics being used for those patients who do not achieve adequate relief from extrapyramidal side effects with amantadine.

Topics: Adult; Age Factors; Aged; Amantadine; Antipsychotic Agents; Basal Ganglia Diseases; Benztropine; Clinical Trials as Topic; Double-Blind Method; Emotions; Female; Humans; Male; Memory; Memory Disorders; Middle Aged; Trihexyphenidyl; Tropanes

Topics: Antidepressive Agents; Antiparkinson Agents; Atropine; Benztropine; Clinical Trials as Topic; Delirium; Drug Combinations; Humans; Memory Disorders; Parasympatholytics; Perphenazine; Placebos; Psychoses, Substance-Induced

A broad range of neuropsychological function was compared in samples of young adult unipolar depressed inpatients with and without psychotic features. Consistent with expectations, the psychotic depressive group demonstrated a broad range of deficit and had more impaired performances than the nonpsychotic group. Relevance of these data for hypotheses concerning psychotic depression as a unique diagnostic entity is discussed. In the context of previous research, the current findings suggest that accounting for individual differences in depression may clarify discrepancies between earlier studies of neuropsychological function in depression, and our understanding of the mechanisms by which depression influences cognition may be refined.

Topics: Adult; Attention; Benztropine; Cognition Disorders; Depressive Disorder; Dopamine; Dopamine Uptake Inhibitors; Dose-Response Relationship, Drug; Female; Humans; Male; Memory Disorders; Neuropsychological Tests; Psychotic Disorders; Severity of Illness Index; Verbal Behavior; Verbal Learning